Abstract 3571: Does Diabetes Accelerate Progression of Calcific Aortic Stenosis?
Background: Calcific aortic stenosis (CAS) is now considered an active disease like atherosclerosis. While diabetes (D) increases risk of aortic valve calcification, its effect on accelerating severity of CAS is not well documented.
Methods: We performed a retrospective analysis of 166 consecutive patients with AS at our tertiary care teaching hospital between1/97 to 3/05. All patients had multiple echocardiograms at least 3 months apart. Two readers independently measured the aortic valve area (AVA) using the continuity equation. CAS was classified based on AVA. CAS severity was categorized using AVA as, mild (>= 1.5 cm2), moderate (1–1.5 cm2), or severe (< 1 cm2). D and non-D patients were compared for differences in sex, hypertension, smoking, statin use using chi-square tests. D and non D were compared for baseline CAS severity using Mantel-Haenszel tests for ordered categorical data and for age, baseline LDL, and baseline AVA using two-sample t-tests. Comparisons between D and non-D for changes in AVA per year were performed using ANOVA.
Results: Study cohort included 164 males with age 70±9 years. Mean follow up time was 2.5 years. Baseline CAS was mild in 66 subjects, moderate in 75 and severe in 25. D subjects smoked less than non D (p=0.02) but all other variables were similar (p>.05). The interaction between D and baseline CAS severity was significant (p=0.0191), indicating comparisons should be viewed by baseline CAS severity. For mild severity and severe severity, D and non-D did not have significantly different change in AVA (p=0.98 for mild, p=0.34 for severe). For moderate baseline AVA severity, D had significantly larger change in AVA than non-D (p=0.0016). Adjusting for statin use did not alter the results.
Conclusion: Severity of CAS progresses faster in D than in non D in subjects with moderately severe CAS at baseline. This progression is independent of statin use