Farrag Azza, Bakhoum Sameh, Salem Mohammed Ali, El-Faramawy Amr, Gergis Emmanuel
Cairo University, Cairo, Egypt.
Heart Vessels. 2013 Jan;28(1):12-8. doi: 10.1007/s00380-011-0205-6. Epub 2011 Nov 3.
Cardiovascular complications are the major cause of diabetes-associated morbidity and mortality. However, not all patients with diabetes are at increased risk for cardiovascular disease (CVD). Coronary artery calcification was found to be a powerful predictor of coronary artery disease (CAD). The presence of extracoronary cardiac calcification as a useful predictor of CAD is not yet established, especially in type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate the relation between extracoronary calcification and extent of CAD in a group of T2DM patients who were scheduled for computed tomographic coronary angiography (CTCA). We prospectively studied 380 patients (151 had T2DM) under the age of 60 years who were scheduled for CTCA because of suspected CAD. Severity of CAD was assessed by Gensini score. Coronary artery calcium score (CACS) as well as calcium score in the aortic valve, mitral annulus, ascending aorta, and descending aorta were measured by a 256-row multidetector computed tomography scanner with dedicated software for calcium calculation. Patients with known CAD were excluded. Diabetic and nondiabetic patients had comparable age and gender distribution. However, the diabetic group had higher Gensini score, CACS, and extracoronary calcium score (ECCS). Logistic regression analyses identified male gender and ECCS as significant predictors for the presence of CAD in diabetic patients. Age, smoking, and ECCS were the significant predictors of CAD in nondiabetic patients. Type 2 diabetic patients had increased coronary and extracoronary calcification. ECCS was found to be a significant predictor of CAD in diabetic and nondiabetic patients only when CACS was not taken into account.
心血管并发症是糖尿病相关发病和死亡的主要原因。然而，并非所有糖尿病患者患心血管疾病（CVD）的风险都会增加。冠状动脉钙化被发现是冠状动脉疾病（CAD）的有力预测指标。冠状动脉外心脏钙化作为CAD的有用预测指标尚未得到证实，尤其是在2型糖尿病（T2DM）患者中。本研究的目的是评估一组计划进行计算机断层扫描冠状动脉造影（CTCA）的T2DM患者冠状动脉外钙化与CAD程度之间的关系。我们前瞻性地研究了380名60岁以下因疑似CAD而计划进行CTCA的患者（其中151名患有T2DM）。CAD的严重程度通过Gensini评分进行评估。使用具有专用钙计算软件的256排多探测器计算机断层扫描仪测量冠状动脉钙化评分（CACS）以及主动脉瓣、二尖瓣环、升主动脉和降主动脉的钙化评分。排除已知患有CAD的患者。糖尿病患者和非糖尿病患者在年龄和性别分布上具有可比性。然而，糖尿病组的Gensini评分、CACS和冠状动脉外钙化评分（ECCS）更高。逻辑回归分析确定男性性别和ECCS是糖尿病患者中CAD存在的重要预测指标。年龄、吸烟和ECCS是非糖尿病患者中CAD的重要预测指标。2型糖尿病患者的冠状动脉和冠状动脉外钙化增加。仅在不考虑CACS时，ECCS才被发现是糖尿病患者和非糖尿病患者中CAD的重要预测指标。
