Diabetes and progression of coronary calcium under the influence of statin therapy

Matthew J. Budoff, Dale Yu, Khurram Nasir, Rajnish Mehrotra, Lynn Chen, Junichiro Takasu, Nisha Agrawal, Sandy T. Liu, Roger S Blumenthal

Research output: Contribution to journalArticle

Abstract

Background: Coronary artery calcium (CAC) is a sensitive marker for the detection of coronary heart disease (CHD). Coronary artery calcification can be accurately quantified using electron beam tomography (EBT). We sought to evaluate the progression of atherosclerosis in asymptomatic persons with type 2 diabetes and measure the influence of statin therapy on CAC progression. Methods: We evaluated 163 asymptomatic patients with type 2 diabetes (120 men, 43 women). Patients were physician referred and underwent 2 consecutive EBT scans at least 1 year apart. Demographic data, risk factors for CHD, and medication use were collected. Patients with symptoms or known CHD were excluded. Results: The mean age was 65 ± 10 years. The mean CAC score at baseline was 651 ± 414. Only 9 (6%) of 163 of participants had scores of 0 at baseline. The time between scans averaged 27 ± 15 months. Patients not treated with statins demonstrated a median annual increase in CAC progression of 20% (4%-44%), whereas statin-treated patients demonstrated increase of 10% (4%-25%) (P =. 0001). Hemoglobin A1c was weakly associated with CAC progression. Conclusions: Asymptomatic diabetic patients show a high prevalence of atherosclerosis based on high frequency of coronary calcification. Statin therapy induced a 50% reduction in the rate of CAC progression. As rapid CAC progression has been associated with coronary events, EBT may serve as a noninvasive method for following atherosclerosis and response to therapy.

Original languageEnglish (US)
Pages (from-to)695-700
Number of pages6
JournalAmerican Heart Journal
Volume149
Issue number4
DOIs
StatePublished - Apr 2005

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Coronary Vessels
Calcium
X Ray Computed Tomography
Coronary Disease
Atherosclerosis
Therapeutics
Type 2 Diabetes Mellitus
Hemoglobins
Demography
Physicians

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Diabetes and progression of coronary calcium under the influence of statin therapy. / Budoff, Matthew J.; Yu, Dale; Nasir, Khurram; Mehrotra, Rajnish; Chen, Lynn; Takasu, Junichiro; Agrawal, Nisha; Liu, Sandy T.; Blumenthal, Roger S.

In: American Heart Journal, Vol. 149, No. 4, 04.2005, p. 695-700.

Research output: Contribution to journalArticle

Budoff, MJ, Yu, D, Nasir, K, Mehrotra, R, Chen, L, Takasu, J, Agrawal, N, Liu, ST & Blumenthal, RS 2005, 'Diabetes and progression of coronary calcium under the influence of statin therapy', American Heart Journal, vol. 149, no. 4, pp. 695-700. https://doi.org/10.1016/j.ahj.2004.07.034
Budoff, Matthew J. ; Yu, Dale ; Nasir, Khurram ; Mehrotra, Rajnish ; Chen, Lynn ; Takasu, Junichiro ; Agrawal, Nisha ; Liu, Sandy T. ; Blumenthal, Roger S. / Diabetes and progression of coronary calcium under the influence of statin therapy. In: American Heart Journal. 2005 ; Vol. 149, No. 4. pp. 695-700.
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AU - Agrawal, Nisha

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N2 - Background: Coronary artery calcium (CAC) is a sensitive marker for the detection of coronary heart disease (CHD). Coronary artery calcification can be accurately quantified using electron beam tomography (EBT). We sought to evaluate the progression of atherosclerosis in asymptomatic persons with type 2 diabetes and measure the influence of statin therapy on CAC progression. Methods: We evaluated 163 asymptomatic patients with type 2 diabetes (120 men, 43 women). Patients were physician referred and underwent 2 consecutive EBT scans at least 1 year apart. Demographic data, risk factors for CHD, and medication use were collected. Patients with symptoms or known CHD were excluded. Results: The mean age was 65 ± 10 years. The mean CAC score at baseline was 651 ± 414. Only 9 (6%) of 163 of participants had scores of 0 at baseline. The time between scans averaged 27 ± 15 months. Patients not treated with statins demonstrated a median annual increase in CAC progression of 20% (4%-44%), whereas statin-treated patients demonstrated increase of 10% (4%-25%) (P =. 0001). Hemoglobin A1c was weakly associated with CAC progression. Conclusions: Asymptomatic diabetic patients show a high prevalence of atherosclerosis based on high frequency of coronary calcification. Statin therapy induced a 50% reduction in the rate of CAC progression. As rapid CAC progression has been associated with coronary events, EBT may serve as a noninvasive method for following atherosclerosis and response to therapy.

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