Coronary Artery Calcium Score Compared with Cardio-Ankle Vascular Index in the Prediction of Cardiovascular Events in Asymptomatic Patients with Type 2 Diabetes

Aim: Coronary artery calcium (CAC) score has a role in stratifying cardiovascular risk in patients with diabetes. Cardio-ankle vascular index (CAVI) is also a useful method to detect coronary artery calcification. This study compares CAC score with CAVI in the prediction of cardiovascular events in patients with diabetes. Methods: From August 2006 to June 2008, a total of 626 patients with diabetes who received CAC score assessment with concomitant tests of ankle-brachial index and CAVI were included in this study. Results: During 4 years of follow-up, 98 participants developed cardiovascular events. There is an increased incidence of coronary revascularization and total cardiovascular events with higher categories of CAC score (P < 0.05 when CAC score >= 100). The logistic regression analyses revealed pooled odd ratios for coronary revascularization, and total cardiovascular events were 1.25 [ 95% confidence interval (CI) 1.03-1.51, P = 0.021] and 1.23 (95% CI 1.07-1.42, P = 0.005), respectively, for high versus low CAVI (CAVI >= 9.0 vs CAVI < 9.0). The logistic regression model revealed that a CAC score of >= 1000 rather than a CAVI of >= 9.0 had a higher predictive value for total cardiovascular events. Conclusions: A CAC score of >= 100 or a CAVI of >= 9.0 predicts future total cardiovascular events in asymptomatic patients with type 2 diabetes. Considering the advantages of CAVI, it can be used as one of the screening tools to reflect coronary atherosclerosis in these patients.