Associations of coronary artery calcified plaque density with mortality in type 2 diabetes: the Diabetes Heart Study
Abstract Background Coronary artery calcified plaque (CAC) is strongly predictive of cardiovascular disease (CVD) events and mortality, both in general populations and individuals with type 2 diabetes at high risk for CVD. CAC is typically reported as an Agatston score, which is weighted for increas...
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| Format: | Article |
| Language: | English |
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BMC
2018-05-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12933-018-0714-z |
| _version_ | 1819261017671073792 |
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| author | Laura M. Raffield Amanda J. Cox Michael H. Criqui Fang-Chi Hsu James G. Terry Jianzhao Xu Barry I. Freedman J. Jeffrey Carr Donald W. Bowden |
| author_facet | Laura M. Raffield Amanda J. Cox Michael H. Criqui Fang-Chi Hsu James G. Terry Jianzhao Xu Barry I. Freedman J. Jeffrey Carr Donald W. Bowden |
| author_sort | Laura M. Raffield |
| collection | DOAJ |
| description | Abstract Background Coronary artery calcified plaque (CAC) is strongly predictive of cardiovascular disease (CVD) events and mortality, both in general populations and individuals with type 2 diabetes at high risk for CVD. CAC is typically reported as an Agatston score, which is weighted for increased plaque density. However, the role of CAC density in CVD risk prediction, independently and with CAC volume, remains unclear. Methods We examined the role of CAC density in individuals with type 2 diabetes from the family-based Diabetes Heart Study and the African American-Diabetes Heart Study. CAC density was calculated as mass divided by volume, and associations with incident all-cause and CVD mortality [median follow-up 10.2 years European Americans (n = 902, n = 286 deceased), 5.2 years African Americans (n = 552, n = 93 deceased)] were examined using Cox proportional hazards models, independently and in models adjusted for CAC volume. Results In European Americans, CAC density, like Agatston score and volume, was consistently associated with increased risk of all-cause and CVD mortality (p ≤ 0.002) in models adjusted for age, sex, statin use, total cholesterol, HDL, systolic blood pressure, high blood pressure medication use, and current smoking. However, these associations were no longer significant when models were additionally adjusted for CAC volume. CAC density was not significantly associated with mortality, either alone or adjusted for CAC volume, in African Americans. Conclusions CAC density is not associated with mortality independent from CAC volume in European Americans and African Americans with type 2 diabetes. |
| first_indexed | 2024-12-23T19:35:07Z |
| format | Article |
| id | doaj.art-edbdafce0c0f4ca6a629ad3146024f74 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-23T19:35:07Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-edbdafce0c0f4ca6a629ad3146024f742022-12-21T17:33:49ZengBMCCardiovascular Diabetology1475-28402018-05-011711810.1186/s12933-018-0714-zAssociations of coronary artery calcified plaque density with mortality in type 2 diabetes: the Diabetes Heart StudyLaura M. Raffield0Amanda J. Cox1Michael H. Criqui2Fang-Chi Hsu3James G. Terry4Jianzhao Xu5Barry I. Freedman6J. Jeffrey Carr7Donald W. Bowden8Department of Genetics, University of North Carolina at Chapel HillCenter for Diabetes Research, Wake Forest School of MedicineDepartment of Family and Preventive Medicine, University of CaliforniaCenter for Diabetes Research, Wake Forest School of MedicineDepartment of Radiology and Radiological Sciences, Vanderbilt UniversityCenter for Diabetes Research, Wake Forest School of MedicineDepartment of Internal Medicine—Section on Nephrology, Wake Forest School of MedicineDepartment of Radiology and Radiological Sciences, Vanderbilt UniversityCenter for Diabetes Research, Wake Forest School of MedicineAbstract Background Coronary artery calcified plaque (CAC) is strongly predictive of cardiovascular disease (CVD) events and mortality, both in general populations and individuals with type 2 diabetes at high risk for CVD. CAC is typically reported as an Agatston score, which is weighted for increased plaque density. However, the role of CAC density in CVD risk prediction, independently and with CAC volume, remains unclear. Methods We examined the role of CAC density in individuals with type 2 diabetes from the family-based Diabetes Heart Study and the African American-Diabetes Heart Study. CAC density was calculated as mass divided by volume, and associations with incident all-cause and CVD mortality [median follow-up 10.2 years European Americans (n = 902, n = 286 deceased), 5.2 years African Americans (n = 552, n = 93 deceased)] were examined using Cox proportional hazards models, independently and in models adjusted for CAC volume. Results In European Americans, CAC density, like Agatston score and volume, was consistently associated with increased risk of all-cause and CVD mortality (p ≤ 0.002) in models adjusted for age, sex, statin use, total cholesterol, HDL, systolic blood pressure, high blood pressure medication use, and current smoking. However, these associations were no longer significant when models were additionally adjusted for CAC volume. CAC density was not significantly associated with mortality, either alone or adjusted for CAC volume, in African Americans. Conclusions CAC density is not associated with mortality independent from CAC volume in European Americans and African Americans with type 2 diabetes.http://link.springer.com/article/10.1186/s12933-018-0714-zCoronary artery calcificationPlaque densityType 2 diabetesMortality |
| spellingShingle | Laura M. Raffield Amanda J. Cox Michael H. Criqui Fang-Chi Hsu James G. Terry Jianzhao Xu Barry I. Freedman J. Jeffrey Carr Donald W. Bowden Associations of coronary artery calcified plaque density with mortality in type 2 diabetes: the Diabetes Heart Study Cardiovascular Diabetology Coronary artery calcification Plaque density Type 2 diabetes Mortality |
| title | Associations of coronary artery calcified plaque density with mortality in type 2 diabetes: the Diabetes Heart Study |
| title_full | Associations of coronary artery calcified plaque density with mortality in type 2 diabetes: the Diabetes Heart Study |
| title_fullStr | Associations of coronary artery calcified plaque density with mortality in type 2 diabetes: the Diabetes Heart Study |
| title_full_unstemmed | Associations of coronary artery calcified plaque density with mortality in type 2 diabetes: the Diabetes Heart Study |
| title_short | Associations of coronary artery calcified plaque density with mortality in type 2 diabetes: the Diabetes Heart Study |
| title_sort | associations of coronary artery calcified plaque density with mortality in type 2 diabetes the diabetes heart study |
| topic | Coronary artery calcification Plaque density Type 2 diabetes Mortality |
| url | http://link.springer.com/article/10.1186/s12933-018-0714-z |
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