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Published on: February 4, 2021
Prevalence and severity of coronary artery disease in diabetic patients with aortic valve calcification
Zhang-wei Chen1, Ju-ying Qian, Ying Jian
1Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
Insights
Type-2 diabetic patients with aortic valve calcification (AVC) show a higher prevalence and severity of coronary artery disease (CAD). This indicates AVC is a significant predictor of CAD in diabetic individuals.
Area of Science:
- Cardiology
- Diabetology
- Vascular Medicine
Background:
- Aortic valve calcification (AVC) is prevalent in the elderly and linked to cardiovascular mortality.
- Diabetes mellitus is a known risk factor for coronary artery disease (CAD).
Purpose of the Study:
- To assess the prevalence and severity of CAD in type-2 diabetic patients with AVC.
- To investigate the association between AVC and CAD in diabetic versus non-diabetic individuals.
Main Methods:
- Coronary angiography was performed on 325 patients presenting with chest pain.
- CAD severity was quantified using the Gensini score and assessment of stenosed vessels.
- Transthoracic echocardiography was used to detect AVC.
Main Results:
- Diabetic patients (n=104) had a similar CAD prevalence (72.1%) compared to non-diabetics (n=221, 66.5%).
- Patients with AVC exhibited higher CAD prevalence, Gensini scores, and stenosed vessels, irrespective of diabetes status.
- Multivariable analysis revealed AVC as a significant predictor of CAD in diabetic patients (OR=3.757, P=0.03), but not in non-diabetics (OR=2.130, P=0.074).
Conclusions:
- Type-2 diabetic patients with AVC have a greater prevalence and severity of CAD.
- AVC is an independent predictor of CAD in type-2 diabetic patients.
Objective:
Aortic valve calcification (AVC) is common in the elderly and associated with increased cardiovascular mortality, while diabetes is one of the confirmed risk factors for coronary artery disease (CAD). In this study, we aimed to evaluate the prevalence and severity of CAD in type-2 diabetic patients with AVC.
Methods:
From June to December in 2007, a total of 325 consecutive patients with chest pain or chest distress were admitted for coronary angiography. The severity of CAD was evaluated by the Gensini score and the number of stenosed vessels. All patients underwent transthoracic echocardiography for detecting AVC.
Results:
Compared with the patients without diabetes (n = 221), the type-2 diabetic patients (n = 104) had a similar prevalence of CAD (66.5% vs. 72.1%, P = 0.312). Further classified by the presence of AVC, patients with AVC had a higher prevalence of CAD, average Gensini score and the number of stenosed vessels, both in the group with and without diabetes. It was also demonstrated that the odds ratio (OR) of AVC for CAD in the diabetic patients was higher than in the non-diabetic ones (3.405 vs 2.515) after chi-square analysis (single-variable). However, at multivariable logistic regression analysis for CAD, the OR of AVC was 3.757 (P = 0.03) in diabetic group, while it did not achieve statistical significance in the non-diabetic group (OR = 2.130, P= 0.074).
Conclusions:
Type-2 diabetic patients with AVC had a higher prevalence of and more severe CAD.
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