Sex Differences in Coronary Artery Calcium and Mortality From Coronary Heart Disease, Cardiovascular Disease, and All Causes in Adults With Diabetes: The Coronary Calcium Consortium
While diabetes has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared with men, whether this is still the case is not clear. Coronary artery calcium (CAC) predicts coronary heart disease (CHD) and CVD in people with diabetes; however, its sex-specif...
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| Published in | Diabetes care Vol. 43; no. 10; pp. 2597 - 2606 |
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| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
American Diabetes Association
01.10.2020
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| Abstract | While diabetes has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared with men, whether this is still the case is not clear. Coronary artery calcium (CAC) predicts coronary heart disease (CHD) and CVD in people with diabetes; however, its sex-specific impact is less defined. We compared the relation of CAC in women versus men with diabetes for total, CVD, and CHD mortality.
We studied adults with diabetes from a large registry of patients with CAC scanning with mortality follow-up over 11.5 years. Cox regression examined the relation of CAC with mortality end points.
Among 4,503 adults with diabetes (32.5% women) aged 21-93 years, 61.2% of women and 80.4% of men had CAC >0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC >100. Age- and risk factor-adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total mortality (1.28 vs. 1.18) (interaction
= 0.01) and CVD mortality (1.47 vs. 1.27) (interaction
= 0.04) but were similar for CHD mortality (1.48 and 1.48). For CVD mortality, HRs with CAC scores of 101-400 and >400 were 3.67 and 6.27, respectively, for women and 1.63 and 3.48, respectively, for men (interaction
= 0.04). For total mortality, HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction
= 0.01).
CAC predicts CHD, CVD, and all-cause mortality in patients with diabetes; however, greater CAC predicts CVD and total mortality more strongly in women. |
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| AbstractList | OBJECTIVE While diabetes has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared with men, whether this is still the case is not clear. Coronary artery calcium (CAC) predicts coronary heart disease (CHD) and CVD in people with diabetes; however, its sex-specific impact is less defined. We compared the relation of CAC in women versus men with diabetes for total, CVD, and CHD mortality. RESEARCH DESIGN AND METHODS We studied adults with diabetes from a large registry of patients with CAC scanning with mortality follow-up over 11.5 years. Cox regression examined the relation of CAC with mortality end points. RESULTS Among 4,503 adults with diabetes (32.5% women) aged 21–93 years, 61.2% of women and 80.4% of men had CAC >0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC >100. Age- and risk factor–adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total mortality (1.28 vs. 1.18) (interaction P = 0.01) and CVD mortality (1.47 vs. 1.27) (interaction P = 0.04) but were similar for CHD mortality (1.48 and 1.48). For CVD mortality, HRs with CAC scores of 101–400 and >400 were 3.67 and 6.27, respectively, for women and 1.63 and 3.48, respectively, for men (interaction P = 0.04). For total mortality, HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction P = 0.01). CONCLUSIONS CAC predicts CHD, CVD, and all-cause mortality in patients with diabetes; however, greater CAC predicts CVD and total mortality more strongly in women. While diabetes has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared with men, whether this is still the case is not clear. Coronary artery calcium (CAC) predicts coronary heart disease (CHD) and CVD in people with diabetes; however, its sex-specific impact is less defined. We compared the relation of CAC in women versus men with diabetes for total, CVD, and CHD mortality.OBJECTIVEWhile diabetes has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared with men, whether this is still the case is not clear. Coronary artery calcium (CAC) predicts coronary heart disease (CHD) and CVD in people with diabetes; however, its sex-specific impact is less defined. We compared the relation of CAC in women versus men with diabetes for total, CVD, and CHD mortality.We studied adults with diabetes from a large registry of patients with CAC scanning with mortality follow-up over 11.5 years. Cox regression examined the relation of CAC with mortality end points.RESEARCH DESIGN AND METHODSWe studied adults with diabetes from a large registry of patients with CAC scanning with mortality follow-up over 11.5 years. Cox regression examined the relation of CAC with mortality end points.Among 4,503 adults with diabetes (32.5% women) aged 21-93 years, 61.2% of women and 80.4% of men had CAC >0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC >100. Age- and risk factor-adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total mortality (1.28 vs. 1.18) (interaction P = 0.01) and CVD mortality (1.47 vs. 1.27) (interaction P = 0.04) but were similar for CHD mortality (1.48 and 1.48). For CVD mortality, HRs with CAC scores of 101-400 and >400 were 3.67 and 6.27, respectively, for women and 1.63 and 3.48, respectively, for men (interaction P = 0.04). For total mortality, HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction P = 0.01).RESULTSAmong 4,503 adults with diabetes (32.5% women) aged 21-93 years, 61.2% of women and 80.4% of men had CAC >0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC >100. Age- and risk factor-adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total mortality (1.28 vs. 1.18) (interaction P = 0.01) and CVD mortality (1.47 vs. 1.27) (interaction P = 0.04) but were similar for CHD mortality (1.48 and 1.48). For CVD mortality, HRs with CAC scores of 101-400 and >400 were 3.67 and 6.27, respectively, for women and 1.63 and 3.48, respectively, for men (interaction P = 0.04). For total mortality, HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction P = 0.01).CAC predicts CHD, CVD, and all-cause mortality in patients with diabetes; however, greater CAC predicts CVD and total mortality more strongly in women.CONCLUSIONSCAC predicts CHD, CVD, and all-cause mortality in patients with diabetes; however, greater CAC predicts CVD and total mortality more strongly in women. OBJECTIVE While diabetes has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared with men, whether this is still the case is not clear. Coronary artery calcium (CAC) predicts coronary heart disease (CHD) and CVD in people with diabetes; however, its sex-specific impact is less defined. We compared the relation of CAC in women versus men with diabetes for total, CVD, and CHD mortality. RESEARCH DESIGN AND METHODS We studied adults with diabetes from a large registry of patients with CAC scanning with mortality follow-up over 11.5 years. Cox regression examined the relation of CAC with mortality end points. RESULTS Among 4,503 adults with diabetes (32.5% women) aged 21–93 years, 61.2% of women and 80.4% of men had CAC >0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC >100. Age- and risk factor–adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total mortality (1.28 vs. 1.18) (interaction P = 0.01) and CVD mortality (1.47 vs. 1.27) (interaction P = 0.04) but were similar for CHD mortality (1.48 and 1.48). For CVD mortality, HRs with CAC scores of 101–400 and >400 were 3.67 and 6.27, respectively, for women and 1.63 and 3.48, respectively, for men (interaction P = 0.04). For total mortality, HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction P = 0.01). CONCLUSIONS CAC predicts CHD, CVD, and all-cause mortality in patients with diabetes; however, greater CAC predicts CVD and total mortality more strongly in women. While diabetes has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared with men, whether this is still the case is not clear. Coronary artery calcium (CAC) predicts coronary heart disease (CHD) and CVD in people with diabetes; however, its sex-specific impact is less defined. We compared the relation of CAC in women versus men with diabetes for total, CVD, and CHD mortality. We studied adults with diabetes from a large registry of patients with CAC scanning with mortality follow-up over 11.5 years. Cox regression examined the relation of CAC with mortality end points. Among 4,503 adults with diabetes (32.5% women) aged 21-93 years, 61.2% of women and 80.4% of men had CAC >0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC >100. Age- and risk factor-adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total mortality (1.28 vs. 1.18) (interaction = 0.01) and CVD mortality (1.47 vs. 1.27) (interaction = 0.04) but were similar for CHD mortality (1.48 and 1.48). For CVD mortality, HRs with CAC scores of 101-400 and >400 were 3.67 and 6.27, respectively, for women and 1.63 and 3.48, respectively, for men (interaction = 0.04). For total mortality, HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction = 0.01). CAC predicts CHD, CVD, and all-cause mortality in patients with diabetes; however, greater CAC predicts CVD and total mortality more strongly in women. |
| Author | Whelton, Seamus P Nasir, Khurram Berman, Daniel S Shaw, Leslee J Miedema, Michael D Rozanski, Alan Blaha, Michael J Wong, Nathan D Budoff, Matthew J Cordola Hsu, Amber R Rumberger, John |
| Author_xml | – sequence: 1 givenname: Nathan D orcidid: 0000-0003-1102-7324 surname: Wong fullname: Wong, Nathan D organization: Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA – sequence: 2 givenname: Amber R surname: Cordola Hsu fullname: Cordola Hsu, Amber R organization: Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA – sequence: 3 givenname: Alan surname: Rozanski fullname: Rozanski, Alan organization: Division of Cardiology, Mount Sinai Morningside, New York, NY – sequence: 4 givenname: Leslee J surname: Shaw fullname: Shaw, Leslee J organization: Department of Radiology, Cornell University, New York, NY – sequence: 5 givenname: Seamus P orcidid: 0000-0001-5914-0735 surname: Whelton fullname: Whelton, Seamus P organization: Division of Cardiology, Ciccarone Center for the Prevention of Cardiovascular Disease, John Hopkins University, Baltimore, MD – sequence: 6 givenname: Matthew J surname: Budoff fullname: Budoff, Matthew J organization: Lindquist Institute, Torrance, CA – sequence: 7 givenname: Khurram surname: Nasir fullname: Nasir, Khurram organization: Division of Cardiology, Baylor College of Medicine, Houston, TX – sequence: 8 givenname: Michael D surname: Miedema fullname: Miedema, Michael D organization: Cardiovascular Prevention, Minneapolis Heart Institute and Foundation, Minneapolis, MN – sequence: 9 givenname: John surname: Rumberger fullname: Rumberger, John organization: Princeton Longevity Center, Princeton, NJ – sequence: 10 givenname: Michael J orcidid: 0000-0001-5138-9683 surname: Blaha fullname: Blaha, Michael J organization: Division of Cardiology, Ciccarone Center for the Prevention of Cardiovascular Disease, John Hopkins University, Baltimore, MD – sequence: 11 givenname: Daniel S orcidid: 0000-0002-3793-9578 surname: Berman fullname: Berman, Daniel S email: bermand@cshs.org organization: Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA bermand@cshs.org |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32816996$$D View this record in MEDLINE/PubMed |
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| Copyright | 2020 by the American Diabetes Association. Copyright American Diabetes Association Oct 1, 2020 2020 by the American Diabetes Association 2020 |
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| Snippet | While diabetes has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared with men, whether this is still the... OBJECTIVE While diabetes has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared with men, whether this is... OBJECTIVE While diabetes has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared with men, whether this is... |
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| SubjectTerms | Adult Adults Aged Aged, 80 and over Arteriosclerosis Calcification (ectopic) Calcium Calcium - blood Calcium - metabolism Cardiovascular and Metabolic Risk Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - epidemiology Cardiovascular Diseases - etiology Cause of Death Consortia Coronary artery Coronary artery disease Coronary Artery Disease - complications Coronary Artery Disease - epidemiology Coronary vessels Diabetes Diabetes mellitus Diabetes Mellitus - epidemiology Diabetes Mellitus - mortality Diabetic Angiopathies - epidemiology Diabetic Angiopathies - mortality Female Gender aspects Health risks Heart diseases Humans Male Men Middle Aged Mortality Research design Risk analysis Risk Assessment Risk Factors Severity of Illness Index Sex Sex Characteristics Sex differences Time Factors United States - epidemiology Vascular Calcification - complications Vascular Calcification - epidemiology Women Young Adult |
| Title | Sex Differences in Coronary Artery Calcium and Mortality From Coronary Heart Disease, Cardiovascular Disease, and All Causes in Adults With Diabetes: The Coronary Calcium Consortium |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/32816996 https://www.proquest.com/docview/2450792276/abstract/ https://www.proquest.com/docview/2436399412/abstract/ https://pubmed.ncbi.nlm.nih.gov/PMC8051260 |
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