Determinants of progression of coronary artery calcification in type 2 diabetes: role of glycemic control and inflammatory/vascular calcification markers.

Description

This article presents the first prospective report on the progression of coronary artery calcification (CAC) in type 2 diabetic subjects without prior coronary heart disease or symptoms at baseline. The authors report on the association between established cardiovascular risk factors as well as three selected biomarkers such as C-reactive protein (CRP), interleukin-6 (IL-6), and osteoprotegerin (OPG). The authors note that all traditional risk factors related to baseline calcification remained predictive of CAC progression with the exception of hyperlipidemia and smoking status. Specifically, serum HbA1c, IL-6, and OPG (although not hs-CRP) were univariate predictors of CAC progression. This study also confirms that CAC progression occurs mainly in persons with pre-existing CAC. Plasma OPG measurements were correlated with baseline/follow-up CAC severity and predicted CAC progression. The authors found that statin therapy failed to inhibit CAC progression. In conclusion, the authors suggest that further prospective studies to evaluate the prognostic value of CAC progression are necessary to establish the usefulness of measuring CAC progression in asymptomatic diabetic subjects.