Major Finding: Two-thirds of 130 patients aged 40 years or younger who had diabetes also had significant coronary atherosclerosis, compared with a 27% prevalence among 3,581 people of the same age without diabetes.
Data Source: Coronary CT examinations of 3,711 young adults at Harbor-UCLA Medical Center.
Disclosures: Dr. Daga said that he had no disclosures. Among his associates on the study, the only disclosure was from Dr. Matthew Budoff, who is on the speakers bureau for General Electric, a company that markets CT equipment.
ATLANTA — Two-thirds of young adults with diabetes who were aged 40 years or younger had significant coronary artery atherosclerosis, on the basis of coronary CT examinations of 130 such patients at one U.S. medical center.
Results from the study also showed that when compared with more than 3,500 similarly aged young adults without diabetes, patients with diabetes had an adjusted, fourfold increased prevalence of coronary atherosclerosis, Dr. Nikhil Daga and his associates from Harbor-UCLA Medical Center reported in a poster at the annual meeting of the American College of Cardiology.
These findings run counter to current recommendations of the American Diabetes Association, which recommend routinely starting statin treatment of patients with diabetes only in those older than 40 years (Diabetes Care 2010;33:S11–61).
“ADA guidelines should consider statin use in patients aged 40 or younger who exhibit subclinical atherosclerosis to reduce future cardiovascular disease events in this vulnerable population,” noted Dr. Daga, a physician at Harbor-UCLA Medical Center in Torrance, Calif., and his associates. The findings also highlighted the useful role that coronary CT can play in identifying subclinical atherosclerosis in these patients, they added.
The researchers performed coronary CT examinations on 3,711 people aged up to age 40 years, including 130 patients with diabetes and 3,581 people without diabetes. The average age of the entire group was 36 years, and 54% were men. The study presumed that the presence of any coronary calcium indicated significant atherosclerosis.
The CT examinations revealed a low coronary calcium score of 1–99 in 52% of the patients with diabetes and in 24% of those without diabetes. An intermediate score of 100-399 occurred in 12% of those with diabetes and in 2% of people without diabetes. A high score of 400 or greater occurred in 4% of those with diabetes and in 0.5% of those without diabetes. Overall, 68% of the patients with diabetes had some degree of coronary artery calcification, compared with a 27% prevalence in people without diabetes.
In an analysis that adjusted for age, sex, dyslipidemia, hypertension, and smoking, patients with diabetes had a statistically significant, fourfold increased risk for having coronary artery calcium, compared with similarly aged young adults without diabetes.