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- Title
Impact of Diabetes Control on Subclinical Atherosclerosis: Analysis from Coronary Computed Tomographic Angiography Registry.
- Authors
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
- Abstract
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.
- Subjects
CORONARY artery stenosis; GLYCOSYLATED hemoglobin; ANGINA pectoris; ATHEROSCLEROTIC plaque; ATHEROSCLEROSIS
- Publication
Diabetes & Metabolism Journal, 2020, Vol 44, Issue 3, p470
- ISSN
2233-6079
- Publication type
Article
- DOI
10.4093/dmj.2019.0073