A. Saremi

Abraira

Arad

Budoff

C. Abraira

Callister

Costacou

Diabetes Control and Complications Trial/Epidemiol

Hamirani

Hokanson

Mohlenkamp

P. D. Reaven

R. J. Anderson

Reaven

T. E. Moritz

Terry

W. C. Duckworth

English

PubMed


                  OBJECTIVE
                  To determine the predictors of progression of calcified atherosclerosis and the effect of intensive glycemic control on this process in patients with type 2 diabetes.
               
               
                  RESEARCH DESIGN AND METHODS
                  As part of the Risk Factors, Atherosclerosis, and Clinical Events in Diabetes (RACED) substudy of the Veterans Affairs Diabetes Trial (VADT), 197 and 189 individuals with type 2 diabetes received baseline and follow-up computed tomographic scans for measurement of coronary and abdominal artery calcium, respectively. Standard and novel risk factors were assessed at baseline, and progression of calcified atherosclerosis was determined by several methods. Progression was defined both as a categorical (square root increase of volumetric scores ≥2.5 mm3) and continuous variable. In addition, annualized percent change of volume scores was determined.
               
               
                  RESULTS
                  After an average follow-up of 4.6 years, &amp;gt;75% of individuals demonstrated coronary (CAC) and abdominal artery calcification (AAC) progression. Progression increased with higher baseline calcium categories but was not influenced by standard risk factors. However, the albumin-to-creatinine ratio (ACR) (P = 0.02) and lipoprotein-associated phospholipase A2 (Lp-PLA2) (P = 0.01) predicted progression of CAC, and these results were not altered by adjustment for age and other traditional risk factors. Treatment assignment (intensive versus standard) within the VADT did not influence CAC or AAC progression, irrespective of baseline calcium category.
               
               
                  CONCLUSIONS
                  In patients with long-standing type 2 diabetes, baseline CAC, Lp-PLA2, and ACR predicted progression of CAC. Intensive glycemic control during the VADT did not reduce progression of calcified atherosclerosis.
               </jats:sec

Aramesh Saremi

Thomas E. Moritz

Robert J. Anderson

Carlos Abraira

William C. Duckworth

Peter D. Reaven

null null

Crossref

Diabetes Care

Rates and Determinants of Coronary and Abdominal Aortic Artery Calcium Progression in the Veterans Affairs Diabetes Trial (VADT)

Investigators for the VADT. Coronary artery and abdominal aorticcalciﬁcationareassociatedwithcardiovascular disease in type 2 diabetes.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2992205

Rates and Determinants of Coronary and Abdominal Aortic Artery Calcium Progression in the Veterans Affairs Diabetes Trial (VADT)

Abstract

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