PMID- 22900680
OWN - NLM
STAT- MEDLINE
DCOM- 20121221
LR  - 20220330
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 11
DP  - 2012 Aug 18
TI  - Prognostic implications of surrogate markers of atherosclerosis in low to 
      intermediate risk patients with type 2 diabetes.
PG  - 101
LID - 10.1186/1475-2840-11-101 [doi]
AB  - BACKGROUND: Type 2 diabetes mellitus (T2DM) patients are at increased risk of 
      developing cardiovascular events. Unfortunately traditional risk assessment 
      scores, including the Framingham Risk Score (FRS), have only modest accuracy in 
      cardiovascular risk prediction in these patients. METHODS: We sought to determine 
      the prognostic values of different non-invasive markers of atherosclerosis, 
      including brachial artery endothelial function, carotid artery atheroma burden, 
      ankle-brachial index, arterial stiffness and computed tomography coronary artery 
      calcium score (CACS) in 151 T2DM Chinese patients that were identified 
      low-intermediate risk from the FRS recalibrated for Chinese (<20% risk in 10 
      years). Patients were prospectively followed-up and presence of atherosclerotic 
      events documented for a mean duration of 61 +/- 16 months. RESULTS: A total of 17 
      atherosclerotic events in 16 patients (11%) occurred during the follow-up period. 
      The mean FRS of the study population was 5.0 +/- 4.6% and area under curve (AUC) 
      from receiver operating characteristic curve analysis for prediction of 
      atherosclerotic events was 0.59 +/- 0.07 (P = 0.21). Among different vascular 
      assessments, CACS > 40 had the best prognostic value (AUC 0.81 +/- 0.06, P < 0.01) 
      and offered significantly better accuracy in prediction compared with FRS (P = 
      0.038 for AUC comparisons). Combination of FRS with CACS or other surrogate 
      vascular markers did not further improve the prognostic values over CACS alone. 
      Multivariate Cox regression analysis identified CACS > 40 as an independent 
      predictor of atherosclerotic events in T2DM patients (Hazards Ratio 27.11, 95% 
      Confidence Interval 3.36-218.81, P = 0.002). CONCLUSIONS: In T2DM patients 
      identified as low-intermediate risk by the FRS, a raised CACS > 40 was an 
      independent predictor for atherosclerotic events.
FAU - Lau, Kui-Kai
AU  - Lau KK
AD  - Division of Neurology, Department of Medicine, Queen Mary Hospital, The 
      University of Hong Kong, Hong Kong SAR, China.
FAU - Wong, Yuen-Kwun
AU  - Wong YK
FAU - Chan, Yap-Hang
AU  - Chan YH
FAU - Yiu, Kai-Hang
AU  - Yiu KH
FAU - Teo, Kay-Cheong
AU  - Teo KC
FAU - Li, Leonard Sheung-Wai
AU  - Li LS
FAU - Ho, Shu-Leong
AU  - Ho SL
FAU - Chan, Koon-Ho
AU  - Chan KH
FAU - Siu, Chung-Wah
AU  - Siu CW
FAU - Tse, Hung-Fat
AU  - Tse HF
LA  - eng
PT  - Journal Article
DEP - 20120818
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
SB  - IM
MH  - Aged
MH  - Ankle Brachial Index
MH  - Area Under Curve
MH  - Atherosclerosis/*diagnosis/*epidemiology/physiopathology
MH  - Brachial Artery/physiopathology
MH  - Carotid Arteries/pathology
MH  - Carotid Artery Diseases/*diagnosis/*epidemiology
MH  - Carotid Intima-Media Thickness
MH  - Chi-Square Distribution
MH  - Comorbidity
MH  - Coronary Angiography/methods
MH  - Coronary Artery Disease/*diagnosis/*epidemiology
MH  - Diabetes Mellitus, Type 2/*epidemiology
MH  - Diabetic Angiopathies/*diagnosis/*epidemiology/physiopathology
MH  - Disease-Free Survival
MH  - Endothelium, Vascular/physiopathology
MH  - Female
MH  - Follow-Up Studies
MH  - Hong Kong/epidemiology
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Plaque, Atherosclerotic
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Pulse Wave Analysis
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Tomography, X-Ray Computed
MH  - Vascular Calcification/diagnosis/epidemiology
MH  - Vascular Stiffness
PMC - PMC3444371
EDAT- 2012/08/21 06:00
MHDA- 2012/12/22 06:00
PMCR- 2012/08/18
CRDT- 2012/08/21 06:00
PHST- 2012/04/13 00:00 [received]
PHST- 2012/08/11 00:00 [accepted]
PHST- 2012/08/21 06:00 [entrez]
PHST- 2012/08/21 06:00 [pubmed]
PHST- 2012/12/22 06:00 [medline]
PHST- 2012/08/18 00:00 [pmc-release]
AID - 1475-2840-11-101 [pii]
AID - 10.1186/1475-2840-11-101 [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2012 Aug 18;11:101. doi: 10.1186/1475-2840-11-101.