WS Chronicle

People with Type 2 diabetes have two to four times the risk of cardiovascular disease compared to people without the disease. The best way for doctors to predict which diabetes patients are at the greatest risk for heart disease is to use a coronary artery calcium (CAC) test in addition to the most commonly used assessment tool, according to researchers at Wake Forest Baptist Medical Center.

[pullquote]Our observations challenge accepted medical knowledge that all people with diabetes have the same risk.[/pullquote]Current medical guidelines recommend treating all diabetes patients as high risk, but the Wake Forest Baptist study found that CAC can identify diabetes patients who are at very high risk for developing potentially fatal cardiovascular disease, as well as those who are at low risk.

“Our observations challenge accepted medical knowledge that all people with diabetes have the same risk. CAC is key in predicting the specific risk level,” said Dr. Donald Bowden, professor of biochemistry at Wake Forest Baptist and senior author of the study, which is published online in the December issue of the journal Diabetes Care.

The community-based Diabetes Heart Study was designed to determine if CAC provided additional information about cardiovascular disease and mortality beyond the Framingham Risk Score, the most commonly used assessment tool. A total of 1,123 people with Type 2 diabetes between 34 to 86 years old were followed for an average of 7.4 years. The study participants were recruited from clinics in western North Carolina and reflect a cross section of families with diabetes-affected members in the region.

CAC uses a CT scan to detect calcium build-up in the arteries of the heart. According to Bowden, the cost of the test is relatively low and the radiation exposure is about half of what someone would get in a year “by just walking around.”