Coronary calcium in adults with type I diabetes - A stronger correlate of clinical coronary artery disease in men than in women

We studied the relationship of coronary artery calcification (CAC), a marke r of coronary atherosclerosis, with prevalent clinical corollary artery dis ease (CAD) and established cardiovascular disease (CVD) risk factors in a t ype 1 diabetic population. At the 10-year follow-up examination of the Pitt sburgh Epidemiology of Diabetes Complications (EDC) Study cohort, 302 adult s (mean age 38.1 +/- 7.8 years) received electron beam tomography (EBT) sca nning of the heart and a clinical examination. Clinical CAD was defined as a confirmed history of myocardial infarction (MI), angiographic stenosis gr eater than or equal to 50%, Pittsburgh EDC Study physician-diagnosed angina , or ischemic electrocardiogram (ECG), CAC correlated with most CVD risk fa ctors. CAC had 84 and 71% sensitivity for clinical CAD in men and women, re spectively and 100% sensitivity for MI or obstructive CAD. A CACS cut point of 400 was the most efficient coronary calcium correlate of CAD. In subjec ts with angina only, CAC sensitivity was 83% in men and 46% in women. In lo gistic regression, CAC, ECG R-R variation, peripheral vascular disease, and Beck Depression Inventory independently correlated with prevalent CAD in m en and overall. Except for CAC, the same variables independently correlated with CAD in women, and age also entered the model, CAC was an independent correlate of MI or obstructive CAD in both sexes and was the strongest inde pendent; correlate in men, but CAC was not independently associated with an gina and ischemic ECG in either sex. It is concluded that GET-detected CAC is strongly correlated with CAD in type 1 diabetes-particularly in men.