Department of Metabolic Medicine Imperial College NHS Healthcare Trust and North West London Diabetes Local Research Network, St Mary's Hospital Praed Street, London W 2 1 NY, United Kingdom.
Atherosclerosis. 2010 Jun;210(2):331-6. doi: 10.1016/j.atherosclerosis.2009.11.026. Epub 2009 Nov 24.
Measurement of coronary artery calcium score (CACS) by electron beam tomography has been shown to a powerful predictor of coronary heart disease events in asymptomatic non-diabetic subjects. In type 2 diabetes, measurement of CACS was found to be a powerful predictor of cardiovascular events which could enhance prediction provided by established risk models. 23% of type 2 diabetic subjects with low CACS were found to be at low risk for cardiovascular events. Moreover mortality was similar for type 2 diabetic and non-diabetic subjects with undetectable coronary artery calcification. Conversely type 2 diabetic subjects with high CACS were identified who were at high cardiovascular risk. Thus not all those with type 2 diabetes are at similar cardiovascular risk. Measurement of CACS enables cardiovascular risk in type 2 diabetes to be stratified so that the level of preventive therapy could be reduced in some and intensified in others. Although prospective data for the power of CACS to predict CHD events in type 1 diabetes are lacking, measurement of CACS could help in deciding on preventive therapy in type 1 diabetes.
电子束计算机断层扫描（EBCT）测量冠状动脉钙评分（CACS）已被证明是预测无症状非糖尿病患者冠心病事件的有力指标。在 2 型糖尿病患者中，CACS 的测量被发现是心血管事件的有力预测指标，可增强既定风险模型提供的预测能力。低 CACS 的 2 型糖尿病患者中有 23%被认为发生心血管事件的风险较低。此外，对于冠状动脉钙化不可检测的 2 型糖尿病和非糖尿病患者，死亡率相似。相反，高 CACS 的 2 型糖尿病患者被确定为具有高心血管风险。因此，并非所有 2 型糖尿病患者都面临相似的心血管风险。CACS 的测量可对 2 型糖尿病患者的心血管风险进行分层，从而降低某些患者的预防治疗水平，加强其他患者的预防治疗水平。尽管缺乏 CACS 预测 1 型糖尿病 CHD 事件的前瞻性数据，但 CACS 的测量有助于决定 1 型糖尿病的预防治疗。
