Also this week MedZine brings you the latest medical news on various medical specialisms. In this editorial, we want to highlight an interesting study that was recently published in the British Medical Journal. Caroline Kramer and her colleagues report the results of a systemetic review and meta-analysis they performed. The objective was to investigate the association of coronary artery calcium score with all cause mortality and cardiovascular events in people with type 2 diabetes.
Kramer e.a. identified studies from Embase, PubMed, and abstracts from the 2011 and 2012 annual meetings of the American Diabetes Association, European Association for the Study of Diabetes, American College of Cardiology, and American Heart Association (2011). For a study to be eligible, it had to be a prospective studies that evaluated baseline coronary artery calcium score in people with type 2 diabetes and subsequent all cause mortality or cardiovascular events (fatal and non-fatal). A total of eight studies were included, which led up to a total of 6521 patiënts and a mean follow up of 5,18 year. One of the things the investigators found, was that the relative risk for all cause mortality or cardiovascular events, or both, comparing a total coronary artery calcium score of ≥10 with a score of <10, was 5.47. The overall sensitivity of a total coronary artery calcium score of ≥10 for this composite outcome was 94% (95% confidence interval 89% to 96%), with a specificity of 34%
Kramer e.a conclude that in people with type 2 diabetes, a coronary artery calcium score of ≥10 predicts all cause mortality or cardiovascular events, or both, and cardiovascular events alone, with high sensitivity but low specificity. According to the investigators, this finding might be clinically important. The finding of a coronary artery calcium score of <10 could facilitate risk stratification by enabling the identification of people at low risk within this high risk population.