Re: America: The world's diet laboratory
- From: Jefferson <fwroy@xxxxxxxxxxxxxxxxxxxx>
- Date: Tue, 23 Oct 2007 22:16:19 -0400
Hi Jim:
http://heartscanblog.blogspot.com/
I've found some things (in the free parts) to be of interest, but I have
reservations about the general approach. That approach is to undergo CT
scans repeatedly to judge changes in calcification of the coronary arteries.
There's a downside to that, both in radiation exposure and cost. And no one
as yet has shown that the current extent of calcification corresponds to the
current risk of plaque rupture and thus heart attack or stroke.
I've undergone (one) CT-scan of coronary arteries. And I can't say that it
added a lot of information to my personal set of risk factors. I think if
you consider abdominal fat (maybe best measured by waist-to-hip ratio at
present), blood pressure, bg control, family and personal history, and lipid
pattern, you won't gain much from a scan, and embarking on a series of scans
to measure progress in controlling coronary calcium just can't be justified.
At first glance at the following references, I would say that the type 2 diabetic should be considered a special attention case for heart scanning. Based on past threads you may well not fit this profile. I have been to cardiologist about 5 times, but nothing significant turned up. Diabetics in my family have a history of heart disease. Four have died by this route.
"RESULTS— Patients with diabetes had a significant increase in the prevalence of CAC scores >=400 (25.9%) compared with the randomly selected (7.2%) and matched (14.4%) nondiabetic control groups. Scores in this range have been reported to be highly predictive for abnormal stress myocardial perfusion tomography and subsequent coronary events.
CONCLUSIONS— Our results, therefore, indicate a substantial prevalence of significant coronary artery disease in an asymptomatic diabetic patient population compared with non-diabetic control subjects. They also suggest that EBCT may be a useful approach for selecting a group of diabetic subjects who would benefit most from additional evaluation for subclinical coronary artery disease." Increased Prevalence of Significant Coronary Artery Calcification in Patients With Diabetes -
http://care.diabetesjournals.org/cgi/content/full/24/2/335
"The increased atherosclerosis seen in patients with diabetes is reflected in increased coronary artery calcium (CAC) measured by electron beam tomography (5,6). CAC is a measure of total coronary atherosclerotic burden that has been validated by autopsy and coronary angiography (7,8). In large studies, CAC has been found to be a significant predictor of cardiovascular events in symptomatic and asymptomatic subjects (9,10). In subjects with type 1 diabetes, CAC is an independent correlate of myocardial infarction and obstructive coronary artery disease (11). The amount of CAC has also been shown to correlate well with the amount of atheromatous plaque in patients with type 2 diabetes (12)." Relationship of Traditional and Nontraditional Cardiovascular Risk Factors to Coronary Artery Calcium in Type 2 Diabetes - http://diabetes.diabetesjournals.org/cgi/content/full/56/3/849
Frank
.
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