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Impact of optimal glycemic control on the progression of coronary artery calcification in asymptomatic patients with diabetes.
Int J Cardiol. 2018 Sep 01; 266:250-253.IJ

Abstract

BACKGROUND

Data on the impact of optimal glycemic control (OGC) on the progression of coronary artery calcification, an important marker for future adverse cardiovascular events in individuals with diabetes are limited.

METHODS

We investigated 1637 asymptomatic adults with diabetes (56 ± 8 years, 88.8% men) and no history of coronary artery disease or stroke, who underwent serial coronary artery calcium (CAC) screening. The median inter-scan period was 3.0 (2.0-4.4) years. The change in CAC was compared base on OGC status. OGC was defined as a follow-up hemoglobin A1C (HbA1C) of <7.0%, and CAC progression was defined by a square root (√) transformed difference between the baseline and follow-up CAC scores (Δ √transformed CAC) of ≥2.5.

RESULTS

Despite no significant difference in the baseline CAC scores, the incidence of CAC progression was lower in the OGC group than in the non-OGC group (45.4% vs. 51.7%; p < 0.013). The two groups differed in the Δ √transformed (OGC, 3.8 ± 6.4; non-OGC, 4.7 ± 6.9; p = 0.016) and annualized Δ √transformed CAC (OGC, 1.1 ± 2.4; non-OGC, 1.4 ± 2.6; p = 0.010) scores. Subgroup analysis showed that OGC significantly reduced the risk of CAC progression in patients aged <65 years and in: smokers, and patients with a body mass index of <25 kg/m2, dyslipidemia, and baseline CAC scores between 1-100 and >400. In multivariate regression analysis, OGC was independently associated with a reduced risk of CAC progression (odds ratio, 0.745, 95% confidence interval, 0.601-0.924; p = 0.007).

CONCLUSION

OGC attenuated the progression of coronary artery calcification in asymptomatic patients with diabetes.

Authors+Show Affiliations

Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea; Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University Health System, South Korea.Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University Health System, South Korea.Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University Health System, South Korea.Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University Health System, South Korea.Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University Health System, South Korea.Division of Cardiology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea.Division of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea.Division of Radiology, Gangnam Heartscan Clinic, Seoul, South Korea.Department of Internal Medicine, Gangnam Heartscan Clinic, Seoul, South Korea.Division of Cardiology, Heart Stroke & Vascular Institute, Samsung Medical Center, Seoul, South Korea.Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University Health System, South Korea. Electronic address: hjchang@yuhs.ac.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

29887457

Citation

Won, Ki-Bum, et al. "Impact of Optimal Glycemic Control On the Progression of Coronary Artery Calcification in Asymptomatic Patients With Diabetes." International Journal of Cardiology, vol. 266, 2018, pp. 250-253.
Won KB, Han D, Lee JH, et al. Impact of optimal glycemic control on the progression of coronary artery calcification in asymptomatic patients with diabetes. Int J Cardiol. 2018;266:250-253.
Won, K. B., Han, D., Lee, J. H., Lee, S. E., Sung, J. M., Choi, S. Y., Chun, E. J., Park, S. H., Han, H. W., Sung, J., Jung, H. O., & Chang, H. J. (2018). Impact of optimal glycemic control on the progression of coronary artery calcification in asymptomatic patients with diabetes. International Journal of Cardiology, 266, 250-253. https://doi.org/10.1016/j.ijcard.2018.03.112
Won KB, et al. Impact of Optimal Glycemic Control On the Progression of Coronary Artery Calcification in Asymptomatic Patients With Diabetes. Int J Cardiol. 2018 Sep 1;266:250-253. PubMed PMID: 29887457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of optimal glycemic control on the progression of coronary artery calcification in asymptomatic patients with diabetes. AU - Won,Ki-Bum, AU - Han,Donghee, AU - Lee,Ji Hyun, AU - Lee,Sang-Eun, AU - Sung,Ji Min, AU - Choi,Su-Yeon, AU - Chun,Eun Ju, AU - Park,Sung Hak, AU - Han,Hae-Won, AU - Sung,Jidong, AU - Jung,Hae Ok, AU - Chang,Hyuk-Jae, PY - 2017/10/31/received PY - 2018/02/19/revised PY - 2018/03/23/accepted PY - 2018/6/12/entrez PY - 2018/6/12/pubmed PY - 2019/1/27/medline KW - Coronary artery calcification KW - Diabetes mellitus KW - Optimal glycemic control SP - 250 EP - 253 JF - International journal of cardiology JO - Int J Cardiol VL - 266 N2 - BACKGROUND: Data on the impact of optimal glycemic control (OGC) on the progression of coronary artery calcification, an important marker for future adverse cardiovascular events in individuals with diabetes are limited. METHODS: We investigated 1637 asymptomatic adults with diabetes (56 ± 8 years, 88.8% men) and no history of coronary artery disease or stroke, who underwent serial coronary artery calcium (CAC) screening. The median inter-scan period was 3.0 (2.0-4.4) years. The change in CAC was compared base on OGC status. OGC was defined as a follow-up hemoglobin A1C (HbA1C) of <7.0%, and CAC progression was defined by a square root (√) transformed difference between the baseline and follow-up CAC scores (Δ √transformed CAC) of ≥2.5. RESULTS: Despite no significant difference in the baseline CAC scores, the incidence of CAC progression was lower in the OGC group than in the non-OGC group (45.4% vs. 51.7%; p < 0.013). The two groups differed in the Δ √transformed (OGC, 3.8 ± 6.4; non-OGC, 4.7 ± 6.9; p = 0.016) and annualized Δ √transformed CAC (OGC, 1.1 ± 2.4; non-OGC, 1.4 ± 2.6; p = 0.010) scores. Subgroup analysis showed that OGC significantly reduced the risk of CAC progression in patients aged <65 years and in: smokers, and patients with a body mass index of <25 kg/m2, dyslipidemia, and baseline CAC scores between 1-100 and >400. In multivariate regression analysis, OGC was independently associated with a reduced risk of CAC progression (odds ratio, 0.745, 95% confidence interval, 0.601-0.924; p = 0.007). CONCLUSION: OGC attenuated the progression of coronary artery calcification in asymptomatic patients with diabetes. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/29887457/Impact_of_optimal_glycemic_control_on_the_progression_of_coronary_artery_calcification_in_asymptomatic_patients_with_diabetes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(17)36784-0 DB - PRIME DP - Unbound Medicine ER -