Abstract 11328: Coronary Artery Calcium and Cardiovascular Outcomes in Patients With Diabetes: A Meta-Analysis

Abstract

Background: Presence of coronary artery calcium (CAC) has been demonstrated to increase mortality and major adverse cardiovascular events (MACE) in both diabetic and non-diabetic patients. A dose response relationship has been suggested between CAC score and cardiovascular outcomes. We performed a meta-analysis to compare the relative risk (RR) of mortality and MACE between categories of CAC scores in patients with diabetes. Methods: We searched the PubMed database to identify studies that investigated cardiovascular outcomes among diabetic patients with CAC. Only studies that used CAC=0 as reference group were included. We performed meta-analyses to obtain pooled RRs for mortality and MACE, as well as the composite outcome of both. Results: A total of 299 publications were identified and 6 studies (N=11,043) were included. With CAC=0 as the reference, CAC=1–100 has a RR of 1.64 (95% confidence interval: 1.34–1.99) for the composite outcome, 1.48 (1.18–1.87) for all-cause mortality, and 2.17 (1.47–3.19) for MACE. CAC=100–400 has a RR of 2.34 (1.9–2.9) for the composite outcome, 2.15 (1.67–2.78) for all-cause mortality, and 2.85 (1.94–4.21) for MACE. CAC>400 has a RR of 3.78 (2.6–5.49) for the composite outcome, 3.29 (2.57–4.21) for all-cause mortality, and 5.87 (1.99–17.32) for MACE. Conclusion Among patients with diabetes, presence of CAC increases risk for both mortality and MACE, and higher CAC scores are associated with higher relative risk. CAC scoring is demonstrated to be a useful tool for prognostication and risk stratification among individuals with diabetes, and our analyses showed that even the pooled RRs of the lowest category had reached statistical significance.