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Multiple risk factor intervention and progression of coronary atherosclerosis in patients with type 2 diabetes

Yu Kataoka1, Mingyuan Shao, Kathy Wolski

  • 1Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.

European Journal of Preventive Cardiology
|February 21, 2012
PubMed

Insights

Intensive management of multiple risk factors significantly slows coronary atherosclerosis progression in diabetic patients with coronary artery disease (CAD). Achieving more treatment goals, including blood sugar and cholesterol, benefits patients with diabetes and CAD.

Area of Science:

  • Cardiology
  • Endocrinology
  • Vascular Biology

Background:

  • Diabetic patients with coronary artery disease (CAD) experience faster atherosclerosis.
  • The effect of intervening on multiple risk factors in this population was previously unstudied.

Purpose of the Study:

  • To assess the impact of achieving multiple risk factor treatment goals on the progression of coronary atherosclerosis in diabetic patients with CAD.

Main Methods:

  • 448 diabetic patients with CAD underwent serial intravascular ultrasound.
  • Progression of atheroma volume was compared based on the number of achieved risk factor treatment goals (HbA1c, LDL-C, triglycerides, blood pressure, hs-CRP).

Main Results:

  • Increasingly achieving risk factor treatment goals was associated with a significant slowing of atheroma progression (PAV p=0.01, TAV p<0.001).
  • This association remained significant after multivariate analysis adjusting for baseline risk factors (PAV p=0.03, TAV p<0.001).

Conclusions:

  • Optimal control of multiple risk factors is crucial for managing coronary atherosclerosis in diabetic patients.
  • Modification of global risk factors is essential for this high-risk population.
Abstract

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