Factors Associated with Aortic Valve Calcification in Type 2 Diabetes - A Steno INTEN-CT substudy

This study aimed to identify clinical factors associated with AVC in individuals with T2D.

This cross-sectional study is a pre-specified substudy of the multicenter randomized Steno INTEN-CT trial (Clinical Trials - INTEN-CT). Participants were eligible if they had T2D without ischemic heart disease and were aged between 55-69 years (men) or 60-74 years (women). All participants underwent non-contrast cardiac computed tomography. AVC was measured in Agatston Units and categorized as 0, 0-300, ≥ 300.Of the 4570 participants, 46% had AVC > 0. With increasing AVC, patients were older, predominantly males, and with significantly more comorbidities. In multivariable ordered logistic regression age (OR per SD 1.54, 95% CI 1.43-1.66), BMI (OR per SD 1.18, 95% CI 1.11-1.25), hypertension (OR 1.21, 95% CI 1.05-1.40), and chronic kidney disease (OR 1.18, 95% CI 1.03-1.36) were associated with higher AVC. Statin use was also associated with higher AVC (OR 1.50, 95% CI 1.27-1.78). Higher LDL cholesterol showed stronger associations with AVC in men than women (OR 1.39, 95% CI 1.24-1.56 vs. OR 1.16, 95% CI 1.02-1.31, p for interaction=0.025). T2D severity (Hemoglobin A1c, T2D duration, and number of antidiabetic drugs) was not associated with AVC.

In individuals with T2D without cardiovascular disease, AVC is prevalent in nearly half of all individuals. Higher AVC was associated with T2D-related comorbidities, but not T2D severity.