Progression of coronary artery calcification is stronger in poorly than in well controlled diabetes: Results from the Heinz Nixdorf Recall Study

Abstract Aim To assess associations between HbA1c and progression of coronary artery calcification (CAC) in persons with and without diabetes. Methods In the Heinz Nixdorf Recall Study, a population-based cohort study in Germany (N=3453, aged 45–74years), CAC was assessed by electron-beam tomography at baseline and at 5-year follow-up. At baseline, participants were divided into five groups: poorly (HbA1c≥7.0%) and well (HbA1c 5 (factor by which CAC after 5-year follow-up is larger than baseline CAC), and categories of CAC change, respectively. Results Relative to group V, adjusted percentage increase of the geometric mean of PF 5 (95% CI) was: 69.1% (33.9%;113.6%), 15.4% (−5.6%;41.1%), −4.1% (−22.2%;18.2%), 4.2% (−5.4%;14.8%) for groups I–IV, respectively. The corresponding odds ratios for annual CAC increase ≥100 Agatston units (reference: Conclusions In known diabetes, CAC progression was stronger in poor diabetes control. For newly detected diabetes diagnosed by HbA1c ≥6.5%, associations with CAC progression were weak.