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Cardiovascular risk factors and mitral annular calcification in type 2 diabetes

Atif N Qasim1, Hashmi Rafeek, Suraj P Rasania

  • 1University of California at San Francisco, San Francisco, CA, USA.

Atherosclerosis
|January 1, 2013
PubMed
Abstract

Insights

Mitral annular calcification (MAC) is common in type 2 diabetes (T2DM). Risk factors include older age, female gender, Caucasian race, and longer diabetes duration, independent of coronary artery calcium (CAC).

Area of Science:

  • Cardiology
  • Endocrinology
  • Radiology

Background:

  • Mitral annular calcification (MAC) is a degenerative process linked to cardiovascular disease and stroke.
  • While MAC is suspected to be more common in type 2 diabetes (T2DM), its characteristics in this population are not well understood due to confounding factors like renal and cardiac disease.
  • This study focuses on identifying risk factors for MAC specifically in T2DM patients without pre-existing renal or cardiac conditions.

Purpose of the Study:

  • To investigate the risk factors associated with the presence and extent of mitral annular calcification (MAC).
  • To analyze these risk factors in a cohort of individuals with type 2 diabetes (T2DM) but without clinical cardiovascular or renal disease.
  • To determine the relationship between MAC and coronary artery calcium (CAC) in this specific diabetic population.

Main Methods:

  • Utilized data from the Penn Diabetes Heart Study (PDHS), a cross-sectional study.
  • Analyzed baseline cardiac computed tomography (CT) scans from 1753 individuals with T2DM and no cardiovascular or renal disease.
  • Quantified MAC using Agatston scores and employed logistic and tobit regression to assess associations with risk factors and CAC.

Main Results:

  • Mitral annular calcification (MAC) was identified in 12.0% of the study participants.
  • Independent risk factors for MAC presence and severity included older age, female gender, Caucasian race, and longer duration of diabetes, even after accounting for CAC.
  • Coronary artery calcium (CAC) showed a strong association with MAC, with an odds ratio of 4.0 (95% CI 2.4-6.6) in multivariable models. Traditional risk factors like hypertension and hyperlipidemia were not significantly associated.

Conclusions:

  • In individuals with type 2 diabetes (T2DM) but without overt cardiovascular or renal disease, age, female gender, Caucasian race, and diabetes duration are significant predictors of mitral annular calcification (MAC).
  • Coronary artery calcium (CAC) is also strongly linked to MAC in this population.
  • The findings suggest that unique mechanisms contributing to MAC formation in diabetic individuals may exist, separate from generalized atherosclerosis, warranting further research.

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