Sex Differences in Coronary Artery Calcium and Mortality From Coronary Heart Disease, Cardiovascular Disease, and All Causes in Adults With Diabetes: The Coronary Calcium Consortium
RESULTS Among 4,503 adults with diabetes (32.5% women) aged 21–93 years, 61.2% of women and 80.4% of men had CAC >0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC >100. Age- and risk factor–adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total mortality (1.28 vs. 1.18) (interaction P = 0.01) and CVD mortality (1.47 vs. 1.27) (interaction P = 0.04) but were similar for CHD mortality (1.48 and 1.48). For CVD mortality, HRs with CAC scores of 101–400 and >400 were 3.67 and 6.27, respectively, for women and 1.63 and 3.48, respectively, for men (interaction P = 0.04). For total mortality, HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction P = 0.01).
CONCLUSIONS CAC predicts CHD, CVD, and all-cause mortality in patients with diabetes; however, greater CAC predicts CVD and total mortality more strongly in women.
Sex Differences in Coronary Artery Calcium and Mortality From Coronary Heart Disease, Cardiovascular Disease, and All Causes in Adults With Diabetes: The Coronary Calcium Consortium — Diabetes Care 2020 Oct; 43(10): 2597-2606. https://doi.org/10.2337/dc20-0166
Coronary calcium score
Coronary Artery Calcium Scan Embraced By New AHA/ACC Cholesterol Guidelines: Will Insurance Coverage Follow?
Thank you Dr. Pearson.
Cardiologists Should Mind Radiation Doses, ESC Says
Because radiation used in imaging tests is proven to cause cancer, they wrote, “cardiologists should make every effort to give ‘the right imaging exam, with the right dose, to the right patient.’
via Cardiologists Should Mind Radiation Doses, ESC Says.
We are seeing more applicant/patient initiated cardiac scans. I recently became aware of a life insurance application where the underwriter requested a repeat cardiac CT scan. The applicant’s cardiologist flatly rejected this course of action in an a asymptomatic patient with a correspondingly low CHD risk score.
Now you understand the cardiologist’s thinking.
Did I hear someone say “litigation risk”?
Coronary Calcium Score Predicts Cardiovascular Mortality in Diabetes
CONCLUSIONS: In T2DM, CAC predicts CVD mortality and meaningfully reclassifies participants, suggesting clinical utility as a risk stratification tool in a population already at increased CVD risk.
via Coronary Calcium Score Predicts Cardiovascular Mortality in Diabetes.
Whoa.
CACS Improves Risk Classification
Conclusion: In this multi-ethnic cohort, addition of CACS to a prediction model based on traditional risk factors significantly improved the classification of risk and placed more individuals in the most extreme risk categories.
Calcium Scoring May Miss CAD
Contrary to guidelines, the absence of coronary artery calcium doesn’t rule out coronary artery disease in symptomatic patients, researchers found in a new study.
In a multicenter clinical trial, 19% of patients with a coronary calcium score of 0 had stenosis of at least 50% in one or more coronary artery segments, according to Carlos E. Rochitte, MD, of the University of São Paulo, Brazil, and colleagues.
Likewise, 20% of vessels seen to be totally occluded on revascularization had no calcium on scans, they reported in the Feb. 16 issue of the Journal of the American College of Cardiology.
“The absence of coronary calcification should not be used as a gatekeeper and should not prevent a symptomatic patient from undergoing angiography,” the researchers wrote.
Oops.
lifeunderwriter.net 