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Relationship of myocardial scar with cardiovascular disease risk factors in the diabetes control and complications trial (DCCT)/epidemiology of diabetes interventions and complications (EDIC) study
https://doi.org/10.1186/1532-429X-12-S1-M6
© Turkbey et al; licensee BioMed Central Ltd. 2010
Published: 21 January 2010
Keywords
- Left Ventricular Mass
- Albumin Excretion Rate
- Myocardial Scar
- Cardiovascular Disease Risk Factor
- Abnormal Left Ventricular
Introduction
Type 1 diabetes is associated with an increased risk of myocardial infarction. Risk factors related to the presence of myocardial scar detected by MRI have not been explored in patients with type 1 diabetes.
Purpose
To determine the prevalence of myocardial scar and to examine cardiovascular disease (CVD) risk factors associated with myocardial scar in a large multi-center study.
Methods
The EDIC study is the observational follow-up (1994-present) of the DCCT cohort. The DCCT (1983-93) was a controlled clinical trial of intensive versus conventional diabetes treatment in 1441 type 1 diabetic subjects. A total of 1019 DCCT/EDIC subjects underwent cardiovascular MRI at 28 centers in the USA and Canada during the 14th year of EDIC. MRI examination, centrally read, included left ventricular (LV) mass, volume and myocardial scar evaluation. A total of 757 eligible patients underwent 15 minute myocardial delayed enhancement MRI following intravenous administration of 0.15 mmol/kg dose of gadolinium contrast. Subjects with gadolinium allergy, dialysis, transplant or GFR < 60 mL/min/1.73 m2 were excluded from the gadolinium study. Images were evaluated for the presence and absence of myocardial scar as well as typical (infarct related) and atypical (non-infarct related) pattern of scar.
Results
Adjusted odds ratios* and 95% confidence intervals for presence versus absence of myocardial scar
Covariate | Adjusted odds ratio* | 95% confidence interval | p - value |
|---|---|---|---|
Males vs. Females | 2.51 | (1.07 - 5.90) | 0.035 |
Age (years) | 1.08 | (1.02 - 1.15) | 0.008 |
Hypertension (yes vs. no) | 2.76 | (1.20 - 6.36) | 0.017 |
Hyperlipidemia (yes vs. no) | 2.02 | (0.80 - 5.09) | 0.136 |
LV Mass(g/m2) | 1.03 | (1.01 - 1.06) | 0.014 |
EF < 50 (yes vs. no) | 10.51 | (4.17 - 26.88) | <0.0001 |
Weighted mean HbA1C | 1.49 | (1.02-2.19) | 0.042 |
Albumin Excretion Rate (AER) > 300 (mg/24 hr) | 3.84 | (1.34 - 10.96) | 0.012 |
Conclusion
The DCCT/EDIC is the first and largest cohort of type 1 diabetic patients evaluated by MRI for myocardial scar. Overall, the prevalence of myocardial scar in DCCT/EDIC was 4.3%. Traditional CVD risk factors (age, gender and hypertension) as well as abnormal LV mass and function, weighted mean HbA1c levels and macroalbuminuria were risk factors for myocardial scar in this multi-center cohort with type 1 diabetes.
Authors’ Affiliations
Copyright
This article is published under license to BioMed Central Ltd.
