Impact of optimal glycemic control on the progression of coronary artery calcification in asymptomatic patients with diabetes

Ki Bum Won, Donghee Han, Ji Hyun Lee, Sang Eun Lee, Ji Min Sung, Su Yeon Choi, Eun Ju Chun, Sung Hak Park, Hae Won Han, Jidong Sung, Hae Ok Jung, Hyuk Jae Chang

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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.

Original languageEnglish
Pages (from-to)250-253
Number of pages4
JournalInternational Journal of Cardiology
Volume266
DOIs
Publication statusPublished - 2018 Sep 1

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    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