Rates and determinants of coronary and abdominal aortic artery calcium progression in the Veterans Affairs Diabetes Trial (VADT)

Aramesh Saremi, Thomas E. Moritz, Robert J. Anderson, Carlos Abraira, William C. Duckworth, Peter D. Reaven

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

OBJECTIVE - To determine the predictors of progression of calcified atherosclerosis and the effect of intensive glycemic control on this process in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS - As part of the Risk Factors, Atherosclerosis, and Clinical Events in Diabetes (RACED) substudy of the Veterans Affairs Diabetes Trial (VADT), 197 and 189 individuals with type 2 diabetes received baseline and follow-up computed tomographic scans for measurement of coronary and abdominal artery calcium, respectively. Standard and novel risk factors were assessed at baseline, and progression of calcified atherosclerosis was determined by several methods. Progression was defined both as a categorical (square root increase of volumetric scores ≥2.5 mm 3) and continuous variable. In addition, annualized percent change of volume scores was determined. RESULTS - After an average follow-up of 4.6 years, >75% of individuals demonstrated coronary (CAC) and abdominal artery calcification (AAC) progression. Progression increased with higher baseline calcium categories but was not influenced by standard risk factors. However, the albumin-to-creatinine ratio (ACR) (P = 0.02) and lipoprotein-associated phospholipase A2 (Lp-PLA2) (P=0.01) predicted progression of CAC, and these results were not altered by adjustment for age and other traditional risk factors. Treatment assignment (intensive versus standard) within the VADT did not influence CAC or AAC progression, irrespective of baseline calcium category. CONCLUSIONS - In patients with long-standing type 2 diabetes, baseline CAC, Lp-PLA2, and ACR predicted progression of CAC. Intensive glycemic control during the VADT did not reduce progression of calcified atherosclerosis.

Original languageEnglish
Pages (from-to)2642-2647
Number of pages6
JournalDiabetes Care
Volume33
Issue number12
DOIs
StatePublished - Dec 2010
Externally publishedYes

Fingerprint

Veterans
Atherosclerosis
Arteries
1-Alkyl-2-acetylglycerophosphocholine Esterase
Type 2 Diabetes Mellitus
Calcium
Albumins
Creatinine
Coronary Vessels
Research Design
Therapeutics

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Rates and determinants of coronary and abdominal aortic artery calcium progression in the Veterans Affairs Diabetes Trial (VADT). / Saremi, Aramesh; Moritz, Thomas E.; Anderson, Robert J.; Abraira, Carlos; Duckworth, William C.; Reaven, Peter D.

In: Diabetes Care, Vol. 33, No. 12, 12.2010, p. 2642-2647.

Research output: Contribution to journalArticle

Saremi, Aramesh ; Moritz, Thomas E. ; Anderson, Robert J. ; Abraira, Carlos ; Duckworth, William C. ; Reaven, Peter D. / Rates and determinants of coronary and abdominal aortic artery calcium progression in the Veterans Affairs Diabetes Trial (VADT). In: Diabetes Care. 2010 ; Vol. 33, No. 12. pp. 2642-2647.
@article{37de3ff56d014043b8c987b84f074a42,
title = "Rates and determinants of coronary and abdominal aortic artery calcium progression in the Veterans Affairs Diabetes Trial (VADT)",
abstract = "OBJECTIVE - To determine the predictors of progression of calcified atherosclerosis and the effect of intensive glycemic control on this process in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS - As part of the Risk Factors, Atherosclerosis, and Clinical Events in Diabetes (RACED) substudy of the Veterans Affairs Diabetes Trial (VADT), 197 and 189 individuals with type 2 diabetes received baseline and follow-up computed tomographic scans for measurement of coronary and abdominal artery calcium, respectively. Standard and novel risk factors were assessed at baseline, and progression of calcified atherosclerosis was determined by several methods. Progression was defined both as a categorical (square root increase of volumetric scores ≥2.5 mm 3) and continuous variable. In addition, annualized percent change of volume scores was determined. RESULTS - After an average follow-up of 4.6 years, >75{\%} of individuals demonstrated coronary (CAC) and abdominal artery calcification (AAC) progression. Progression increased with higher baseline calcium categories but was not influenced by standard risk factors. However, the albumin-to-creatinine ratio (ACR) (P = 0.02) and lipoprotein-associated phospholipase A2 (Lp-PLA2) (P=0.01) predicted progression of CAC, and these results were not altered by adjustment for age and other traditional risk factors. Treatment assignment (intensive versus standard) within the VADT did not influence CAC or AAC progression, irrespective of baseline calcium category. CONCLUSIONS - In patients with long-standing type 2 diabetes, baseline CAC, Lp-PLA2, and ACR predicted progression of CAC. Intensive glycemic control during the VADT did not reduce progression of calcified atherosclerosis.",
author = "Aramesh Saremi and Moritz, {Thomas E.} and Anderson, {Robert J.} and Carlos Abraira and Duckworth, {William C.} and Reaven, {Peter D.}",
year = "2010",
month = "12",
doi = "10.2337/dc10-1388",
language = "English",
volume = "33",
pages = "2642--2647",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "12",

}

TY - JOUR

T1 - Rates and determinants of coronary and abdominal aortic artery calcium progression in the Veterans Affairs Diabetes Trial (VADT)

AU - Saremi, Aramesh

AU - Moritz, Thomas E.

AU - Anderson, Robert J.

AU - Abraira, Carlos

AU - Duckworth, William C.

AU - Reaven, Peter D.

PY - 2010/12

Y1 - 2010/12

N2 - OBJECTIVE - To determine the predictors of progression of calcified atherosclerosis and the effect of intensive glycemic control on this process in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS - As part of the Risk Factors, Atherosclerosis, and Clinical Events in Diabetes (RACED) substudy of the Veterans Affairs Diabetes Trial (VADT), 197 and 189 individuals with type 2 diabetes received baseline and follow-up computed tomographic scans for measurement of coronary and abdominal artery calcium, respectively. Standard and novel risk factors were assessed at baseline, and progression of calcified atherosclerosis was determined by several methods. Progression was defined both as a categorical (square root increase of volumetric scores ≥2.5 mm 3) and continuous variable. In addition, annualized percent change of volume scores was determined. RESULTS - After an average follow-up of 4.6 years, >75% of individuals demonstrated coronary (CAC) and abdominal artery calcification (AAC) progression. Progression increased with higher baseline calcium categories but was not influenced by standard risk factors. However, the albumin-to-creatinine ratio (ACR) (P = 0.02) and lipoprotein-associated phospholipase A2 (Lp-PLA2) (P=0.01) predicted progression of CAC, and these results were not altered by adjustment for age and other traditional risk factors. Treatment assignment (intensive versus standard) within the VADT did not influence CAC or AAC progression, irrespective of baseline calcium category. CONCLUSIONS - In patients with long-standing type 2 diabetes, baseline CAC, Lp-PLA2, and ACR predicted progression of CAC. Intensive glycemic control during the VADT did not reduce progression of calcified atherosclerosis.

AB - OBJECTIVE - To determine the predictors of progression of calcified atherosclerosis and the effect of intensive glycemic control on this process in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS - As part of the Risk Factors, Atherosclerosis, and Clinical Events in Diabetes (RACED) substudy of the Veterans Affairs Diabetes Trial (VADT), 197 and 189 individuals with type 2 diabetes received baseline and follow-up computed tomographic scans for measurement of coronary and abdominal artery calcium, respectively. Standard and novel risk factors were assessed at baseline, and progression of calcified atherosclerosis was determined by several methods. Progression was defined both as a categorical (square root increase of volumetric scores ≥2.5 mm 3) and continuous variable. In addition, annualized percent change of volume scores was determined. RESULTS - After an average follow-up of 4.6 years, >75% of individuals demonstrated coronary (CAC) and abdominal artery calcification (AAC) progression. Progression increased with higher baseline calcium categories but was not influenced by standard risk factors. However, the albumin-to-creatinine ratio (ACR) (P = 0.02) and lipoprotein-associated phospholipase A2 (Lp-PLA2) (P=0.01) predicted progression of CAC, and these results were not altered by adjustment for age and other traditional risk factors. Treatment assignment (intensive versus standard) within the VADT did not influence CAC or AAC progression, irrespective of baseline calcium category. CONCLUSIONS - In patients with long-standing type 2 diabetes, baseline CAC, Lp-PLA2, and ACR predicted progression of CAC. Intensive glycemic control during the VADT did not reduce progression of calcified atherosclerosis.

UR - http://www.scopus.com/inward/record.url?scp=79951691814&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79951691814&partnerID=8YFLogxK

U2 - 10.2337/dc10-1388

DO - 10.2337/dc10-1388

M3 - Article

VL - 33

SP - 2642

EP - 2647

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 12

ER -