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冠状动脉钙化积分作为2型糖尿病无症状患者心血管风险的预测指标

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

作者信息

Z Siddiqi, J Fatima, R Karoli, F Kareem, S Kandhuri, A Tiwari, S Raza

机构信息

Professor , Corresponding Author.

Professor and Head, Department of Medicine, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh.

出版信息

J Assoc Physicians India. 2020 Feb;68(2):23-26.

PMID:32009357
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.

摘要

引言

在上个世纪,糖尿病已成为一种流行病。南亚人群中糖尿病的高患病率以及该地区存在的其他心血管危险因素,使得冠状动脉疾病(CAD)与糖尿病之间的关系更为显著。鉴于糖尿病患者对CAD的高易感性,这些患者被视为高危人群。人们一直强调即使在无症状状态下也要尽早识别CAD。冠状动脉钙化评分(CACS)因其非侵入性和相对较高的敏感性,有望成为无症状患者检测CAD的良好筛查工具。因此,我们进行了一项横断面研究,以评估招募时无症状(CAD方面)的2型糖尿病患者的冠状动脉钙化评分。

方法

招募了140名年龄小于60岁、就诊时无症状的CAD患者,并通过CT扫描进行冠状动脉钙化评分。

结果

在我们的研究人群中,通过冠状动脉钙化评分评估的CAD风险患病率为35.7%。糖尿病病程和吸烟与冠状动脉钙化严重程度增加相关,显示出CAD风险显著增加。血管造影结果与冠状动脉钙化评分之间也存在显著相关性(p<0.001)。

结论

这项横断面研究表明,即使在无症状且相对年轻的糖尿病患者中,冠状动脉疾病的患病率也很高,冠状动脉钙化评分可以作为一种有用的非侵入性方法来测量这种亚临床风险。

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