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- Cardiovascular Risk/Epidemiology
- Impact of Diabetes Control on Subclinical Atherosclerosis: Analysis from Coronary Computed Tomographic Angiography Registry
- Gyung-Min Park, Chang Hoon Lee, Seung-Whan Lee, Sung-Cheol Yun, Young-Hak Kim, Yong-Giun Kim, Ki-Bum Won, Soe Hee Ann, Shin-Jae Kim, Dong Hyun Yang, Joon-Won Kang, Tae-Hwan Lim, Eun Hee Koh, Woo Je Lee, Min-Seon Kim, Joong-Yeol Park, Hong-Kyu Kim, Jaewon Choe, Sang-Gon Lee
- Diabetes Metab J. 2020;44(3):470-479. Published online November 22, 2019
- DOI: https://doi.org/10.4093/dmj.2019.0073
- 8,662 View
- 69 Download
- 8 Web of Science
- 8 Crossref
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Abstract
PDF
Supplementary Material
PubReader Background There are limited data on the impact of diabetes control on the risk of subclinical coronary atherosclerosis.
Methods We analyzed 6,434 consecutive asymptomatic individuals without previous history of coronary artery disease who underwent coronary computed tomographic angiography (CCTA) (mean age, 53.7±7.6 years and 4,694 men [73.0%]). The degree and extent of subclinical coronary atherosclerosis were assessed by CCTA, and ≥50% diameter stenosis was defined as significant. A cardiac event was defined as a composite of all-cause death, myocardial infarction, unstable angina, or coronary revascularization. Study participants were categorized as normal (
n =5,319), controlled diabetes (glycosylated hemoglobin [HbA1c] <7%,n =747), or uncontrolled diabetes (HbA1c ≥7%,n =368), respectively.Results Compared with normal individuals, there were no statistically significant differences in the risk of for any atherosclerotic plaque (odds ratio [OR], 1.16; 95% confidence interval [CI], 0.98 to 1.38;
P =0.086) and significant coronary artery stenosis (OR, 1.08; 95% CI, 0.82 to 1.42;P =0.583) in controlled diabetic individuals. In contrast, uncontrolled diabetic individuals had consistently higher risks of any atherosclerotic plaque (OR, 2.16; 95% CI, 1.70 to 2.75;P <0.001) and significant coronary artery stenosis (OR, 3.34; 95% CI, 2.52 to 4.43;P <0.001) than normal individuals. During a follow-up of median 5.4 years, there was no significant difference in cardiac events between normal and controlled diabetic individuals (P =0.365). However, uncontrolled diabetes was associated with an increased risk of cardiac events compared with normal individuals (P <0.001) and controlled diabetic individuals (P =0.023).Conclusion Asymptomatic uncontrolled diabetes was associated with significant subclinical coronary atherosclerosis with subsequent high risk for cardiac events.
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Citations
Citations to this article as recorded by
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Cardiovascular Diabetology.2020;[Epub] CrossRef - Choosing Antithrombotic Therapy in Patients with Coronary Heart Disease and Type 2 Diabetes Mellitus: How to Reduce the Risk of Death
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