Gobardhan Sanjay N, Dimitriu-Leen Aukelien C, van Rosendael Alexander R, van Zwet Erik W, Roos Cornelis J, Oemrawsingh Pranobe V, Kharagjitsingh Aan V, Jukema J Wouter, Delgado Victoria, Schalij Martin J, Bax Jeroen J, Scholte Arthur J H A
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; The Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.
Am J Cardiol. 2017 Mar 1;119(5):705-711. doi: 10.1016/j.amjcard.2016.11.029. Epub 2016 Dec 2.
The aim of this study was to explore the association between various cardiovascular (CV) risk scores and coronary atherosclerotic burden on coronary computed tomography angiography (CTA) in South Asians with type 2 diabetes mellitus and matched whites. Asymptomatic type 2 diabetic South Asians and whites were matched for age, gender, body mass index, hypertension, and hypercholesterolemia. Ten-year CV risk was estimated using different risk scores (United Kingdom Prospective Diabetes Study [UKPDS], Framingham Risk Score [FRS], AtheroSclerotic CardioVascular Disease [ASCVD], and Joint British Societies for the prevention of CVD [JBS3]) and categorized into low- and high-risk groups. The presence of coronary artery calcium (CAC) and obstructive coronary artery disease (CAD; ≥50% stenosis) was assessed using coronary CTA. Finally, the relation between coronary atherosclerosis on CTA and the low- and high-risk groups was compared. UKPDS, FRS, and ASCVD showed no differences in estimated CV risk between 159 South Asians and 159 matched whites. JBS3 showed a significant greater absolute CV risk in South Asians (18.4% vs 14.2%, p <0.01). Higher presence of CAC score >0 (69% vs 55%, p <0.05) and obstructive CAD (39% vs 27%, p <0.05) was observed in South Asians. South Asians categorized as high risk, using UKPDS, FRS, and ASCVD, showed more CAC and CAD compared than whites. JBS3 showed no differences. In conclusion, asymptomatic South Asians with type 2 diabetes mellitus more frequently showed CAC and obstructive CAD than matched whites in the population categorized as high-risk patients using UKPDS, FRS, and ASCVD as risk estimators. However, JBS3 seems to correlate best to CAC and CAD in both ethnicity groups compared with the other risk scores.
本研究旨在探讨2型糖尿病南亚人和匹配的白人中，各种心血管（CV）风险评分与冠状动脉计算机断层扫描血管造影（CTA）上冠状动脉粥样硬化负担之间的关联。无症状的2型糖尿病南亚人和白人在年龄、性别、体重指数、高血压和高胆固醇血症方面进行了匹配。使用不同的风险评分（英国前瞻性糖尿病研究[UKPDS]、弗雷明汉风险评分[FRS]、动脉粥样硬化性心血管疾病[ASCVD]以及英国预防心血管疾病联合学会[JBS3]）估算10年心血管风险，并将其分为低风险和高风险组。使用冠状动脉CTA评估冠状动脉钙化（CAC）和阻塞性冠状动脉疾病（CAD；狭窄≥50%）的存在情况。最后，比较CTA上冠状动脉粥样硬化与低风险和高风险组之间的关系。UKPDS、FRS和ASCVD显示，159名南亚人和159名匹配的白人之间估算的心血管风险没有差异。JBS3显示，南亚人的绝对心血管风险显著更高（18.4%对14.2%，p<0.01）。在南亚人中观察到更高的CAC评分>0（69%对55%，p<0.05）和阻塞性CAD（39%对27%，p<0.05）。使用UKPDS、FRS和ASCVD分类为高风险的南亚人比白人显示出更多的CAC和CAD。JBS3显示没有差异。总之，在使用UKPDS、FRS和ASCVD作为风险评估指标分类为高风险患者的人群中，无症状的2型糖尿病南亚人比匹配的白人更频繁地出现CAC和阻塞性CAD。然而，与其他风险评分相比，JBS3似乎在两个种族群体中与CAC和CAD的相关性最佳。
