E997 JACC March 12, 2013 Volume 61, Issue 10 Imaging INTERPLAY OF DIABETES MELLITUS, SMOKING AND CORONARY ARTERY CALCIFICATION FOR THE PREDICTION OF ALL-CAUSE MORTALITY IN ASYMPTOMATIC INDIVIDUALS Poster Contributions Poster Sessions, Expo North Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m. Session Title: Imaging: CT/Multimodality VI Abstract Category: 20. Imaging: CT/Multimodality Presentation Number: 1230-368 Authors: Shivda Pandey, Baptist Health South Florida, Miami, FL, USA Background: Extensive evidence shows that diabetes mellitus (DM) and smoking (SM) amplify the risk of cardiovascular disease. In the current study we evaluated the effect of combined DM/smoking status and its interplay with burden of coronary artery calcium(CAC) on risk of all-cause mortality. Methods: The study cohort consisted of 44,052 (54±10 years, 54% men) consecutive asymptomatic individuals free of known coronary heart disease referred for CAC testing to improve risk assessment. Individuals were grouped as follows (DM(-)/SM (-), n=36,216 82%), (DM(-)/SM (+), n=5,448, 13%), (DM(+)/SM (-), n=1,816 4%), (DM(+)/SM (+), n=572, 1%). Results: Overall 901 deaths (2.05%) were recorded during a mean follow-up of 5.6 ± 2.6 years. When stratified according to CAC scores (figure), the lowest fatality rate was observed in patients with no CAC and DM(-)/SM (-), whereas those with CAC≥400 and (DM(+)/SM (+)had the highest all-cause fatality rate. In multivariable analyses adjusting for CAC and other risk factors, as compared to DM (-)/SM (-), the HR for all-cause mortality among smokers alone, diabetics alone and both conditions were 3.44 (2.89-4.10), 2.52 (2.02-3.13) and 5.04 (3.67-6.93). Conclusions: The combination of smoking and DM is associated with significantly higher risk of death across the entire spectrum of subclinical coronary atherosclerosis.

INTERPLAY OF DIABETES MELLITUS, SMOKING AND CORONARY ARTERY CALCIFICATION FOR THE PREDICTION OF ALL-CAUSE MORTALITY IN ASYMPTOMATIC INDIVIDUALS

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Page 1: INTERPLAY OF DIABETES MELLITUS, SMOKING AND CORONARY ARTERY CALCIFICATION FOR THE PREDICTION OF ALL-CAUSE MORTALITY IN ASYMPTOMATIC INDIVIDUALS

E997JACC March 12, 2013Volume 61, Issue 10

Imaging

inTerplay of diaBeTes melliTus, smoking and coronary arTery calcificaTion for The predicTion of all-cause morTaliTy in asympTomaTic individuals

Poster ContributionsPoster Sessions, Expo NorthSunday, March 10, 2013, 9:45 a.m.-10:30 a.m.

Session Title: Imaging: CT/Multimodality VIAbstract Category: 20. Imaging: CT/MultimodalityPresentation Number: 1230-368

Authors: Shivda Pandey, Baptist Health South Florida, Miami, FL, USA

Background: Extensive evidence shows that diabetes mellitus (DM) and smoking (SM) amplify the risk of cardiovascular disease. In the current study we evaluated the effect of combined DM/smoking status and its interplay with burden of coronary artery calcium(CAC) on risk of all-cause mortality.

methods: The study cohort consisted of 44,052 (54±10 years, 54% men) consecutive asymptomatic individuals free of known coronary heart disease referred for CAC testing to improve risk assessment. Individuals were grouped as follows (DM(-)/SM (-), n=36,216 82%), (DM(-)/SM (+), n=5,448, 13%), (DM(+)/SM (-), n=1,816 4%), (DM(+)/SM (+), n=572, 1%).

results: Overall 901 deaths (2.05%) were recorded during a mean follow-up of 5.6 ± 2.6 years. When stratified according to CAC scores (figure), the lowest fatality rate was observed in patients with no CAC and DM(-)/SM (-), whereas those with CAC≥400 and (DM(+)/SM (+)had the highest all-cause fatality rate. In multivariable analyses adjusting for CAC and other risk factors, as compared to DM (-)/SM (-), the HR for all-cause mortality among smokers alone, diabetics alone and both conditions were 3.44 (2.89-4.10), 2.52 (2.02-3.13) and 5.04 (3.67-6.93).

conclusions: The combination of smoking and DM is associated with significantly higher risk of death across the entire spectrum of subclinical coronary atherosclerosis.