Photo Credit: Liudmila Chernetska
The following is a summary of “Impact of Coronary Artery Calcium on Mortality and Cardiovascular Events in Metabolic Syndrome and Diabetes among Younger Adults,” published in the February 2024 issue of Cardiology by Masrouri et al.
Researchers conducted a retrospective study to assess whether coronary artery calcium (CAC) testing aids in predicting cardiovascular disease (CVD) and mortality independently of traditional risk factors (RFs) in younger individuals with metabolic syndrome (MetS) and diabetes (DM).
They combined data from 5174 individuals aged 38-55 years from the CARDIA (Coronary Artery Risk Development in Young Adults; n=3047, year 20) and MESA (Multi-Ethnic Study of Atherosclerosis; n=2127, visit 1) studies who underwent computed tomography of CAC. The mean age (SD) of participants (44.7% men) was 47.3 (4.2) years. Multivariable Cox proportional hazards regression models were utilized to calculate HR for CVD, coronary heart disease (CHD), and all-cause death.
The result showed that 1085 (21.0%) had prevalent CAC at baseline. Among them, 461 (8.9%) had DM, 1025 (19.8%) had MetS without DM, and 3688 (71.3%) had neither condition. Over a median follow-up of 14.2 years, 256 (5.0%) participants died, and 304 (5.9%) experienced CVD, while 188 (3.6%) had CHD events. The CAC score was independently associated with incident CVD in those with DM (HR: 1.22 [95% CI: 1.08-1.38]), MetS (1.18 [1.08-1.31]), and neither condition (1.36 [1.26-1.46]). The HRs for CAC ≥100 were 2.70 (1.25-5.83), 3.29 (1.87-5.79), and 6.30 (4.02-9.86). Comparable associations were observed for CHD and death. The impact of CAC ≥100 on CVD and CHD was less pronounced in the presence of DM (P interaction <0.05). Even after adjusting for hemoglobin A1c levels, the association of CAC with all outcomes in individuals with DM remained significant.
Investigators concluded that higher CAC scores at midlife predict increased cardiovascular events and death over 15 years, but the impact is weaker in individuals with diabetes.
Source: academic.oup.com/eurjpc/advance-article-abstract/doi/10.1093/eurjpc/zwae039/7602451
