Abstract 17328: Presence of Albuminuria can Determine Eligible Subjects for the Screening of Coronary Artery Disease in Patients with Diabetes Mellitus

Abstract

Object: Controversy still exists regarding the screening of subjects with diabetes mellitus (DM) for coronary artery disease (CAD). The hypothesis of this study states that presence of albuminuria can determine eligible subjects for the screening of CAD, evidenced by coronary computed tomography angiography (cCTA), in patients with DM.

Methods: This study included 3,990 asymptomatic subjects (DM: 302, 7.6%). An 1:5 matching between DM and non-DM subjects was performed by a propensity score calculated using age, gender, hypertension, dyslipidemia, creatinine, total cholesterol, high-, and low- density lipoprotein cholesterol. Albuminuria was defined has albumin-to-creatinine ratio greater than 30mg/g, and the risk of coronary atherosclerosis [coronary artery calcium score (CACS) >100, the presence of CAD and obstructive CAD (greater than 50% stenosis)] was calculated in subgroup of non-DM, DM without Albuminuria, and DM with Albuminuria.

Results: We selected 1812 subjects (1510 non-DM vs. 302 DM, propensity-score matched) and all the baseline characteristics were similar in both groups except more hypertensive patients were in DM (33% vs. 40%, P=0.026). Albuminuria was observed in 52 patients (17%) among DM. The risk of coronary atherosclerosis was increased in DM compared to non-DM. However, in subset of DM without albuminuria, significant difference in risk of coronary atherosclerosis was not observed between DM and non-DM any longer. The difference between DM and non-DM could be explained through increased risk of coronary atherosclerosis observed in DM with albuminuria compared to non-DM.

Conclusions: The presence of albuminuria remarkably contributes the risk of coronary atherosclerosis in asymptomatic DM. Screening for CAD could be considered in patients with asymptomatic DM, who present with albuminuria.