| Impact of Subclinical Atherosclerosis on Cardiovascular Disease Events in Individuals With Metabolic Syndrome and Diabetes: The Multi-Ethnic Study of Atherosclerosis. | |
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MedLine Citation:
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PMID: 21844289 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE While metabolic syndrome (MetS) and diabetes confer greater cardiovascular disease (CVD) risk, recent evidence suggests that these individuals have a wide range of risk. We evaluated whether screening for coronary artery calcium (CAC) and carotid intimal medial thickness (CIMT) can improve CVD risk stratification over traditional risk factors (RFs) in people with MetS and diabetes. RESEARCH DESIGN AND METHODS We assessed CAC and CIMT in 6,603 people aged 45-84 years in the Multi-Ethnic Study of Atherosclerosis (MESA). Cox regression examined the association of CAC and CIMT with coronary heart disease (CHD) and CVD over 6.4 years in MetS and diabetes. RESULTS MetS comprised 1,686 (25%) subjects without diabetes and 881 (13%) subjects with diabetes. Annual CHD event rates were 1.0% among MetS and 1.5% for diabetes. Ethnicity and RF-adjusted hazard ratios for CHD for CAC 1-99 to ≥ 400 vs. 0 in subjects with neither MetS nor diabetes ranged from 2.6 to 9.5, in those with MetS, they ranged from 3.9 to 11.9, and in those with diabetes, they ranged from 2.9 to 6.2 (all P < 0.05 to P < 0.001); findings were similar for CVD. CAC increased the C-statistic for events (P < 0.001) over RFs and CIMT in each group while CIMT added negligibly to prediction over RFs. CONCLUSIONS Individuals with MetS or diabetes have low risks for CHD when CAC or CIMT is not increased. Prediction of CHD and CVD events are improved by CAC more than by CIMT. Screening for CAC or CIMT can stratify risk in people with MetS and diabetes and support latest recommendations regarding CAC screening in those with diabetes. |
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Authors:
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Shaista Malik; Matthew J Budoff; Ronit Katz; Roger S Blumenthal; Alain G Bertoni; Khurram Nasir; Moyses Szklo; R Graham Barr; Nathan D Wong |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-15 |
Journal Detail:
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Title: Diabetes care Volume: - ISSN: 1935-5548 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7805975 Medline TA: Diabetes Care Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Heart Disease Prevention Program, Division of Cardiology, University of California-Irvine, Irvine, California. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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