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Impact of optimal glycemic control on the progression of coronary artery calcification in asymptomatic patients with diabetes.

Authors
 Ki-Bum Won  ;  Donghee Han  ;  Ji Hyun Lee  ;  Sang-Eun Lee  ;  Ji Min Sung  ;  Su-Yeon Choi  ;  Eun Ju Chun  ;  Sung Hak Park  ;  Hae-Won Han  ;  Jidong Sung  ;  Hae Ok Jung  ;  Hyuk-Jae Chang 
Citation
 International Journal of Cardiology, Vol.266 : 250-253, 2018 
Journal Title
 International Journal of Cardiology 
ISSN
 0167-5273 
Issue Date
2018
Keywords
Coronary artery calcification ; Diabetes mellitus ; Optimal glycemic control
Abstract
BACKGROUND: Data on the impact of optimal glycemic control (OGC) on the progression of coronary artery calcification, an important marker for future adverse cardiovascular events in individuals with diabetes are limited. METHODS: We investigated 1637 asymptomatic adults with diabetes (56 ± 8 years, 88.8% men) and no history of coronary artery disease or stroke, who underwent serial coronary artery calcium (CAC) screening. The median inter-scan period was 3.0 (2.0-4.4) years. The change in CAC was compared base on OGC status. OGC was defined as a follow-up hemoglobin A1C (HbA1C) of <7.0%, and CAC progression was defined by a square root (√) transformed difference between the baseline and follow-up CAC scores (Δ √transformed CAC) of ≥2.5. RESULTS: Despite no significant difference in the baseline CAC scores, the incidence of CAC progression was lower in the OGC group than in the non-OGC group (45.4% vs. 51.7%; p < 0.013). The two groups differed in the Δ √transformed (OGC, 3.8 ± 6.4; non-OGC, 4.7 ± 6.9; p = 0.016) and annualized Δ √transformed CAC (OGC, 1.1 ± 2.4; non-OGC, 1.4 ± 2.6; p = 0.010) scores. Subgroup analysis showed that OGC significantly reduced the risk of CAC progression in patients aged <65 years and in: smokers, and patients with a body mass index of <25 kg/m2, dyslipidemia, and baseline CAC scores between 1-100 and >400. In multivariate regression analysis, OGC was independently associated with a reduced risk of CAC progression (odds ratio, 0.745, 95% confidence interval, 0.601-0.924; p = 0.007). CONCLUSION: OGC attenuated the progression of coronary artery calcification in asymptomatic patients with diabetes.
DOI
10.1016/j.ijcard.2018.03.112
Appears in Collections:
1. Journal Papers (연구논문) > 5. Research Institutes (연구소) > Yonsei Cardiovascular Research Institute (심혈관연구소)
1. Journal Papers (연구논문) > 2. College of Dentistry (치과대학) > Others (기타)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
성지민(Sung, Ji Min)
이지현(Lee, Jee Hyun)
장혁재(Chang, Hyuck Jae) ORCID logo https://orcid.org/0000-0002-6139-7545
한동희(Han, Donghee)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163426
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