TY - JOUR
T1 - Coronary Artery Calcium Scores in Older Adults With Diabetes and Their Association With Diabetes-Specific Risk Enhancers (from the Atherosclerosis Risk in Communities Study)
AU - Obisesan, Olufunmilayo H.
AU - Orimoloye, Olusola A.
AU - Wang, Frances M.
AU - Dardari, Zeina A.
AU - Selvin, Elizabeth
AU - Boakye, Ellen
AU - Osei, Albert D.
AU - Honda, Yasuyuki
AU - Dzaye, Omar
AU - Pankow, James
AU - Coresh, Josef
AU - Howard-Claudio, Candace M.
AU - Nasir, Khurram
AU - Matsushita, Kunihiro
AU - Blaha, Michael J.
N1 - Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute (Bethesda, Maryland), National Institutes of Health (Bethesda, Maryland), Department of Health, and Human Services (Washington, District of Columbia), under contract numbers HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700004I , HHSN268201700005I .
Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/8/15
Y1 - 2023/8/15
N2 - Coronary artery calcium (CAC) is a validated marker of atherosclerotic cardiovascular disease (ASCVD) risk; however, it is not routinely incorporated in ASCVD risk prediction in older adults with diabetes. We sought to assess the CAC distribution among this demographic and its association with “diabetes-specific risk enhancers,” which are known to be associated with increased ASCVD risk. We used the ARIC (Atherosclerosis Risk in Communities) study data, including adults aged >75 years with diabetes, who had their CAC measured at ARIC visit 7 (2018 to 2019). The demographic characteristics of participants and their CAC distribution were analyzed using descriptive statistics. Multivariable-adjusted logistic regression models were used to estimate the association between diabetes-specific risk enhancers (duration of diabetes, albuminuria, chronic kidney disease, retinopathy, neuropathy, and ankle-brachial index) and elevated CAC, adjusting for age, gender, race, education level, dyslipidemia, hypertension, physical activity, smoking status, and family history of coronary heart disease. The mean age in our sample was 79.9 (SD 3.97) years, with 56.6% women and 62.1% White. The CAC scores were heterogenous, and the median CAC score was higher in participants with a greater number of diabetes risk enhancers, regardless of gender. In the multivariable-adjusted logistic regression models, participants with ≥2 diabetes-specific risk enhancers had greater odds of elevated CAC than those with <2 (odds ratio 2.31, 95% confidence interval 1.34 to 3.98). In conclusion, the distribution of CAC was heterogeneous among older adults with diabetes, with the CAC burden associated with the number of diabetes risk–enhancing factors present. These data may have implications for prognostication in older patients with diabetes and supports the possible incorporation of CAC in the assessment of cardiovascular disease risk in this population.
AB - Coronary artery calcium (CAC) is a validated marker of atherosclerotic cardiovascular disease (ASCVD) risk; however, it is not routinely incorporated in ASCVD risk prediction in older adults with diabetes. We sought to assess the CAC distribution among this demographic and its association with “diabetes-specific risk enhancers,” which are known to be associated with increased ASCVD risk. We used the ARIC (Atherosclerosis Risk in Communities) study data, including adults aged >75 years with diabetes, who had their CAC measured at ARIC visit 7 (2018 to 2019). The demographic characteristics of participants and their CAC distribution were analyzed using descriptive statistics. Multivariable-adjusted logistic regression models were used to estimate the association between diabetes-specific risk enhancers (duration of diabetes, albuminuria, chronic kidney disease, retinopathy, neuropathy, and ankle-brachial index) and elevated CAC, adjusting for age, gender, race, education level, dyslipidemia, hypertension, physical activity, smoking status, and family history of coronary heart disease. The mean age in our sample was 79.9 (SD 3.97) years, with 56.6% women and 62.1% White. The CAC scores were heterogenous, and the median CAC score was higher in participants with a greater number of diabetes risk enhancers, regardless of gender. In the multivariable-adjusted logistic regression models, participants with ≥2 diabetes-specific risk enhancers had greater odds of elevated CAC than those with <2 (odds ratio 2.31, 95% confidence interval 1.34 to 3.98). In conclusion, the distribution of CAC was heterogeneous among older adults with diabetes, with the CAC burden associated with the number of diabetes risk–enhancing factors present. These data may have implications for prognostication in older patients with diabetes and supports the possible incorporation of CAC in the assessment of cardiovascular disease risk in this population.
KW - Humans
KW - Female
KW - Aged
KW - Aged, 80 and over
KW - Male
KW - Coronary Artery Disease/epidemiology
KW - Calcium/metabolism
KW - Cardiovascular Diseases/epidemiology
KW - Coronary Vessels/diagnostic imaging
KW - Risk Assessment
KW - Atherosclerosis/epidemiology
KW - Diabetes Mellitus/epidemiology
KW - Risk Factors
KW - Vascular Calcification/diagnostic imaging
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UR - http://www.scopus.com/inward/citedby.url?scp=85163200086&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2023.06.011
DO - 10.1016/j.amjcard.2023.06.011
M3 - Article
C2 - 37385177
AN - SCOPUS:85163200086
SN - 0002-9149
VL - 201
SP - 219
EP - 223
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -