rtery Calcium Testing for Guiding Aspirin Use Among Asymptomatic Individuals With Diabetes

OBJECTIVEdIt is unclear whether coronary artery calcium (CAC) is effective for risk strat-ifying patients with diabetes in whom treatment decisions are uncertain.RESEARCH DESIGN AND METHODSdOf 44,052 asymptomatic individuals referredforCACtesting,westudied2,384individualswithdiabetes.Subjectswerefollowedforameanof5.6 6 2.6 years for the end point of all-cause mortality.RESULTSdThere were 162 deaths (6.8%) in the population. CAC was a strong predictor ofmortality across age-groups (age ,50, 50–59, $60), sex, and risk factor burden (0 vs.$1additionalriskfactor).Inindividualswithoutaclearindicationforaspirinpercurrentguidelines,CAC stratified risk, identifying patients above and below the 10% risk threshold of presumedaspirin benefit.CONCLUSIONSdCACcan helpriskstratifyindividuals with diabetes and mayaid inselec-tionofpatientswhomaybenefitfromtherapiessuchaslow-doseaspirinforprimaryprevention.Diabetes Care35:624–626, 2012