MEDIAL ARTERY CALCIFICATION PREDICTS CARDIOVASCULAR MORTALITY IN PATIENTS WITH NIDDM

OBJECTIVE- To study the predictive value of medial artery calcificatio n (Monckeberg's sclerosis) in relation to 10-year cardiovascular morta lity in patients with noninsulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS- We studied the predictive value of thigh medial and intimal artery calcifications to 10-year cardiovascular mor tality in a well-characterized group of 133 middle-aged, newly diagnos ed patients with NIDDM (70 men and 63 women). RESULTS- At baseline, me dial artery calcifications were found in 17% of the patients and intim al-type calcifications were found in 23%. During the follow-up, 21% of the diabetic patients died from cardiovascular causes. The age-adjust ed odds ratio for cardiovascular mortality was 4.2 (95% confidence int ervals: 1.5-11.3) for medial-type and 1.6 (0.6-4.3) for intimal-type c alcifications. In multiple logistic regression analysis, including age , sex, systolic blood pressure, low-density- and high-density-lipoprot ein cholesterol, very-low-density lipoprotein triglycerides, smoking, body mass index, fasting serum insulin, blood glucose, urinary albumin , and ischemic ECG changes, as well as the intimal artery calcificatio n, the medial artery calcification was the dominant factor predicting cardiovascular mortality. CONCLUSIONS - In this study medial artery ca lcification was a strong independent predictor of cardiovascular morta lity in patients with newly diagnosed NIDDM. Whether these subjects ha d a longer duration of hyperglycemia before the diagnosis than those w ithout medial artery calcifications remains unknown.