Coronary Artery Calcium Score as a Predictor of Cardiovascular Risk in Asymptomatic Patients of Type 2 Diabetes

Abstract

Introduction: Diabetes mellitus has assumed the status of an epidemic in the last century. High prevalence of diabetes in South Asian population and presence of other cardiovascular risk factors in this region, make up the relationship between coronary artery disease (CAD) and diabetes more pronounced. Keeping in view the high susceptibility of diabetic patients for CAD, these patients are recognized as a high risk group .Emphasis has been laid on the early recognition of CAD, even in silent or asymptomatic state. Coronary artery calcium scoring (CACS), owing to its non-invasive nature and a relatively high sensitivity holds promise as a good screening tool for detection of CAD in asymptomatic patients. Hence, a cross sectional study was carried out to estimate coronary artery calcium scores in type 2 diabetics who were asymptomatic (for CAD) at the time of recruitment.

Methodology: 140 type 2 diabetes mellitus patients < 60 years who were asymptomatic for CAD at presentation were recruited and coronary artery calcium scoring via CT scan was performed.

Results: The prevalence of CAD risk as assessed by coronary artery calcium scores was 35.7% in our study population. Duration of diabetes and smoking showed a significantly increased CAD risk by having greater severity of coronary calcification. A significant correlation between angiography findings and coronary artery calcium scores was also seen (p<0.001).

Conclusion: This cross sectional study shows that there is a high prevalence of coronary artery disease even in asymptomatic and relatively young diabetic population and coronary artery calcium scoring can be a useful and noninvasive method for measurement of this subclinical risk.