TY - JOUR
T1 - Diabetes, subclinical atherosclerosis and multiple cardiovascular risk factors in hard-to-reach asymptomatic patients
AU - Mamudu, Hadii M.
AU - Alamian, Arsham
AU - Paul, Timir
AU - Subedi, Pooja
AU - Wang, Liang
AU - Jones, Antwan
AU - Alamin, Ali E.
AU - Stewart, David
AU - Blackwell, Gerald
AU - Budoff, Matthew
N1 - Funding Information:
We would like to thank the Colleges of Public Health, Medicine, and Pharmacy at East Tennessee State University (ETSU) for supporting the ETSU Cardiovascular Research Group on this project. We would also like to thank Wellmont CVA Heart Institute (now Ballad Health) for providing the researchers with the electronic medical record data. We thank the Office of Research and Sponsored Program and the ETSU Office of Equity and Diversity for providing the funds to support data cleaning and management and research assistants. Finally, we would like to say special thanks to all colleagues and graduate assistants who reviewed different versions of the manuscript. The author(s) received no financial support for the research, authorship and/or publication of this article.
Publisher Copyright:
© The Author(s) 2018.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Aim: To examine the association of cardiovascular disease risk factors with and their cumulative effect on coronary artery calcium in hard-to-reach asymptomatic patients with diabetes. Methods: A total of 2563 community-dwelling asymptomatic subjects from Central Appalachia participated in coronary artery calcium screening at a heart centre. Binary variable was used to indicate that coronary artery calcium was either present or absent. Independent variables consisted of demographic and modifiable risk factors and medical conditions. Descriptive statistics and multinomial logistic regression analyses were conducted. Results: In total, 55.8% and 13.7% of study participants had subclinical atherosclerosis (coronary artery calcium ⩾1) and diabetes, respectively. The presence of coronary artery calcium was higher in subjects with diabetes (68.5%) than those without (53.8%). Compared to subjects without diabetes with coronary artery calcium = 0, obesity, hypertension, hypercholesterolaemia and smoking increased the odds of the presence of coronary artery calcium (coronary artery calcium score ⩾1) regardless of diabetes status; however, with larger odds ratios in subjects with diabetes. Compared to subjects without diabetes with coronary artery calcium score = 0, having 3, 4 and ⩾5 risk factors increased the odds of presence of coronary artery calcium in subjects with diabetes by 14.06 (confidence interval = 3.26–62.69), 32.30 (confidence interval = 7.41–140.82) and 47.12 (confidence interval = 10.35–214.66) times, respectively. Conclusion: There is a need for awareness about subclinical atherosclerosis in patients with diabetes and more research about coronary artery calcium in subpopulations of patients.
AB - Aim: To examine the association of cardiovascular disease risk factors with and their cumulative effect on coronary artery calcium in hard-to-reach asymptomatic patients with diabetes. Methods: A total of 2563 community-dwelling asymptomatic subjects from Central Appalachia participated in coronary artery calcium screening at a heart centre. Binary variable was used to indicate that coronary artery calcium was either present or absent. Independent variables consisted of demographic and modifiable risk factors and medical conditions. Descriptive statistics and multinomial logistic regression analyses were conducted. Results: In total, 55.8% and 13.7% of study participants had subclinical atherosclerosis (coronary artery calcium ⩾1) and diabetes, respectively. The presence of coronary artery calcium was higher in subjects with diabetes (68.5%) than those without (53.8%). Compared to subjects without diabetes with coronary artery calcium = 0, obesity, hypertension, hypercholesterolaemia and smoking increased the odds of the presence of coronary artery calcium (coronary artery calcium score ⩾1) regardless of diabetes status; however, with larger odds ratios in subjects with diabetes. Compared to subjects without diabetes with coronary artery calcium score = 0, having 3, 4 and ⩾5 risk factors increased the odds of presence of coronary artery calcium in subjects with diabetes by 14.06 (confidence interval = 3.26–62.69), 32.30 (confidence interval = 7.41–140.82) and 47.12 (confidence interval = 10.35–214.66) times, respectively. Conclusion: There is a need for awareness about subclinical atherosclerosis in patients with diabetes and more research about coronary artery calcium in subpopulations of patients.
KW - Appalachia
KW - cardiovascular diseases
KW - coronary artery calcium
KW - coronary artery disease
KW - diabetes
KW - multiple risk factors
KW - Subclinical atherosclerosis
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U2 - 10.1177/1479164118791654
DO - 10.1177/1479164118791654
M3 - Article
C2 - 30113211
AN - SCOPUS:85052567907
VL - 15
SP - 519
EP - 527
JO - Diabetes and Vascular Disease Research
JF - Diabetes and Vascular Disease Research
SN - 1479-1641
IS - 6
ER -
