Screening diabetic patients for coronary artery calcification improves diagnosis, treatment of heart disease

Researchers found that testing coronary artery calcification through imaging dramatically enhanced the ability to predict which patients would do poorly in the future. Researchers also found that patients with diabetes who had coronary artery calcification were more than five times as likely to suffer a heart attack, stroke or death than those in which no coronary calcium was identified.

Results of the study of more than 400 diabetic patients were presented during the American College of Cardiology 64th Annual Scientific Session in San Diego.

"The fact that a patient has been diagnosed with diabetes does not itself indicate that the patient will have the same risk of a future cardiovascular event as every other diabetic patient," said Viet Le, PA, lead author of the study and researcher at the Intermountain Medical Center Heart Institute. "Every patient is different, and this study encourages more individualized patient care for diabetics to help reduce the risk of heart events and prevent the onset of heart disease."

Historically, when evaluating patients for risk of future heart disease, diabetic patients have been included side-by-side with patients who have already suffered a heart attack or stroke. However, this study indicates that all diabetic patients may not be created equal in relation to future heart attack or stroke risk.

"This highly accurate assessment strategy may well allow us to provide a more personalized treatment approach to each diabetic patient based on his or her individual cardiovascular risk," said Brent Muhlestein, MD, co-director of cardiovascular research at the Intermountain Medical Center Heart Institute.

Patients in the study were in a sub-set of the primary FaCTor64 study, which was released last November, who had received coronary computed tomography angiography (CCTA) on a 64-slice CT scanner to assess coronary artery calcification. The patients were then followed for four years to assess outcomes in conjunction with coronary artery calcification distribution.

Researchers believe coronary artery calcification imaging is a promising tool for refining heart risk assessment and personalizing treatment approaches in not only individuals with diabetes, but also those with low to intermediate risk based upon existing risk factors, and they are now planning the next study to look at a broader population.