Evaluation of the predictive value of coronary artery calcium score for obstructive coronary artery disease in asymptomatic Korean patients with type 2 diabetes mellitus

Ki Bum Won, Hyuk Jae Chang, Hiroyuki Niinuma, Jimin Sung, Sanghoon Shin, In Jeong Cho, Chi Young Shim, Geu Ru Hong, Young Jin Kim, Byung Wook Choi, Namsik Chung

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

BACKGROUND: Compared with coronary computed tomographic angiography (CCTA), the coronary artery calcium score (CACS) may be limited in predicting adverse cardiovascular events in asymptomatic diabetic patients. METHODS: We evaluated the predictive value of CACS for obstructive coronary plaques (OCPs) assessed by CCTA in 328 consecutive asymptomatic patients with type 2 diabetes mellitus who had an estimated glomerular filtration rate greater than 60ml/min/1.73m. RESULTS: In total, 29 (9%) patients had OCPs: calcified or mixed OCPs and noncalcified OCPs were found in 26 (8%) and three (1%) patients, respectively. On the basis of a CACS of 0, 1-10, 11-100, and greater than 100, OCPs were found in 2, 5, 15, and 36% of patients, respectively. On receiver operating characteristic curve analysis, the optimal cutoff CACS for predicting OCPs was found to be 33, with 83% sensitivity and 81% specificity (area under the curve, 0.853; 95% confidence interval, 0.777-0.930; P<0.001). Positive and negative predictive values of a CACS of 33 for OCPs were 30 and 98%, respectively. On multivariate logistic regression analysis, age [odds ratio (OR), 1.09], microalbuminuria (OR, 3.43), current smoking (OR, 3.93), and CACS greater than 33 (OR, 15.85) were found to be independently associated with an increased risk for OCPs (P<0.05, respectively). The predictive significance of CACS greater than 33 for OCPs improved after considering the status of microalbuminuria and current smoking. CONCLUSION: These findings suggest that CACS is an effective gatekeeper for evaluating obstructive coronary artery disease using CCTA in asymptomatic Korean patients with type 2 diabetes mellitus who have near-normal kidney function.

Original languageEnglish
Pages (from-to)150-156
Number of pages7
JournalCoronary artery disease
Volume26
Issue number2
DOIs
Publication statusPublished - 2015 Mar 13

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Type 2 Diabetes Mellitus
Coronary Artery Disease
Coronary Vessels
Calcium
Odds Ratio
Angiography
Smoking
Glomerular Filtration Rate
ROC Curve
Area Under Curve
Logistic Models
Regression Analysis
Confidence Intervals
Kidney
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Won, Ki Bum ; Chang, Hyuk Jae ; Niinuma, Hiroyuki ; Sung, Jimin ; Shin, Sanghoon ; Cho, In Jeong ; Shim, Chi Young ; Hong, Geu Ru ; Kim, Young Jin ; Choi, Byung Wook ; Chung, Namsik. / Evaluation of the predictive value of coronary artery calcium score for obstructive coronary artery disease in asymptomatic Korean patients with type 2 diabetes mellitus. In: Coronary artery disease. 2015 ; Vol. 26, No. 2. pp. 150-156.
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abstract = "BACKGROUND: Compared with coronary computed tomographic angiography (CCTA), the coronary artery calcium score (CACS) may be limited in predicting adverse cardiovascular events in asymptomatic diabetic patients. METHODS: We evaluated the predictive value of CACS for obstructive coronary plaques (OCPs) assessed by CCTA in 328 consecutive asymptomatic patients with type 2 diabetes mellitus who had an estimated glomerular filtration rate greater than 60ml/min/1.73m. RESULTS: In total, 29 (9{\%}) patients had OCPs: calcified or mixed OCPs and noncalcified OCPs were found in 26 (8{\%}) and three (1{\%}) patients, respectively. On the basis of a CACS of 0, 1-10, 11-100, and greater than 100, OCPs were found in 2, 5, 15, and 36{\%} of patients, respectively. On receiver operating characteristic curve analysis, the optimal cutoff CACS for predicting OCPs was found to be 33, with 83{\%} sensitivity and 81{\%} specificity (area under the curve, 0.853; 95{\%} confidence interval, 0.777-0.930; P<0.001). Positive and negative predictive values of a CACS of 33 for OCPs were 30 and 98{\%}, respectively. On multivariate logistic regression analysis, age [odds ratio (OR), 1.09], microalbuminuria (OR, 3.43), current smoking (OR, 3.93), and CACS greater than 33 (OR, 15.85) were found to be independently associated with an increased risk for OCPs (P<0.05, respectively). The predictive significance of CACS greater than 33 for OCPs improved after considering the status of microalbuminuria and current smoking. CONCLUSION: These findings suggest that CACS is an effective gatekeeper for evaluating obstructive coronary artery disease using CCTA in asymptomatic Korean patients with type 2 diabetes mellitus who have near-normal kidney function.",
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Evaluation of the predictive value of coronary artery calcium score for obstructive coronary artery disease in asymptomatic Korean patients with type 2 diabetes mellitus. / Won, Ki Bum; Chang, Hyuk Jae; Niinuma, Hiroyuki; Sung, Jimin; Shin, Sanghoon; Cho, In Jeong; Shim, Chi Young; Hong, Geu Ru; Kim, Young Jin; Choi, Byung Wook; Chung, Namsik.

In: Coronary artery disease, Vol. 26, No. 2, 13.03.2015, p. 150-156.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Evaluation of the predictive value of coronary artery calcium score for obstructive coronary artery disease in asymptomatic Korean patients with type 2 diabetes mellitus

AU - Won, Ki Bum

AU - Chang, Hyuk Jae

AU - Niinuma, Hiroyuki

AU - Sung, Jimin

AU - Shin, Sanghoon

AU - Cho, In Jeong

AU - Shim, Chi Young

AU - Hong, Geu Ru

AU - Kim, Young Jin

AU - Choi, Byung Wook

AU - Chung, Namsik

PY - 2015/3/13

Y1 - 2015/3/13

N2 - BACKGROUND: Compared with coronary computed tomographic angiography (CCTA), the coronary artery calcium score (CACS) may be limited in predicting adverse cardiovascular events in asymptomatic diabetic patients. METHODS: We evaluated the predictive value of CACS for obstructive coronary plaques (OCPs) assessed by CCTA in 328 consecutive asymptomatic patients with type 2 diabetes mellitus who had an estimated glomerular filtration rate greater than 60ml/min/1.73m. RESULTS: In total, 29 (9%) patients had OCPs: calcified or mixed OCPs and noncalcified OCPs were found in 26 (8%) and three (1%) patients, respectively. On the basis of a CACS of 0, 1-10, 11-100, and greater than 100, OCPs were found in 2, 5, 15, and 36% of patients, respectively. On receiver operating characteristic curve analysis, the optimal cutoff CACS for predicting OCPs was found to be 33, with 83% sensitivity and 81% specificity (area under the curve, 0.853; 95% confidence interval, 0.777-0.930; P<0.001). Positive and negative predictive values of a CACS of 33 for OCPs were 30 and 98%, respectively. On multivariate logistic regression analysis, age [odds ratio (OR), 1.09], microalbuminuria (OR, 3.43), current smoking (OR, 3.93), and CACS greater than 33 (OR, 15.85) were found to be independently associated with an increased risk for OCPs (P<0.05, respectively). The predictive significance of CACS greater than 33 for OCPs improved after considering the status of microalbuminuria and current smoking. CONCLUSION: These findings suggest that CACS is an effective gatekeeper for evaluating obstructive coronary artery disease using CCTA in asymptomatic Korean patients with type 2 diabetes mellitus who have near-normal kidney function.

AB - BACKGROUND: Compared with coronary computed tomographic angiography (CCTA), the coronary artery calcium score (CACS) may be limited in predicting adverse cardiovascular events in asymptomatic diabetic patients. METHODS: We evaluated the predictive value of CACS for obstructive coronary plaques (OCPs) assessed by CCTA in 328 consecutive asymptomatic patients with type 2 diabetes mellitus who had an estimated glomerular filtration rate greater than 60ml/min/1.73m. RESULTS: In total, 29 (9%) patients had OCPs: calcified or mixed OCPs and noncalcified OCPs were found in 26 (8%) and three (1%) patients, respectively. On the basis of a CACS of 0, 1-10, 11-100, and greater than 100, OCPs were found in 2, 5, 15, and 36% of patients, respectively. On receiver operating characteristic curve analysis, the optimal cutoff CACS for predicting OCPs was found to be 33, with 83% sensitivity and 81% specificity (area under the curve, 0.853; 95% confidence interval, 0.777-0.930; P<0.001). Positive and negative predictive values of a CACS of 33 for OCPs were 30 and 98%, respectively. On multivariate logistic regression analysis, age [odds ratio (OR), 1.09], microalbuminuria (OR, 3.43), current smoking (OR, 3.93), and CACS greater than 33 (OR, 15.85) were found to be independently associated with an increased risk for OCPs (P<0.05, respectively). The predictive significance of CACS greater than 33 for OCPs improved after considering the status of microalbuminuria and current smoking. CONCLUSION: These findings suggest that CACS is an effective gatekeeper for evaluating obstructive coronary artery disease using CCTA in asymptomatic Korean patients with type 2 diabetes mellitus who have near-normal kidney function.

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