Amal Haujir, Preman Kumarathurai, Jacob V. Stidsen, Per Løgstrup Poulsen, Kristian Løkke Funck, Batool J Y Mohammad, Emil Johannes Ravn, Selma Hasific, Camilla Engelsgaard, Ramshanker Ramanathan, Lene Helleskov Madsen, Monija Mrgan Hansen, Morten Böttcher, Anna Pietraszek, M Olsen, Klaus F. Kofoed, Marek Karon, Tine W. Hansen, Kristian Eskesen, Elena Calderon, Jess Lambrechtsen, Marie‐Annick Clavel, Kristian Altern Øvrehus, Axel CP Diederichsen, Jordi S Dahl
AIM: This study aimed to identify clinical factors associated with AVC in individuals with T2D. METHODS AND RESULTS: This cross-sectional study is a pre-specified substudy of the multicenter randomized Steno INTEN-CT trial (Clinical Trials - INTEN-CT). Participants were eligible if they had T2D without ischemic heart disease and were aged between 55-69 years (men) or 60-74 years (women). All participants underwent non-contrast cardiac computed tomography. AVC was measured in Agatston Units and categorized as 0, 0-300, ≥ 300.Of the 4570 participants, 46% had AVC > 0. With increasing AVC, patients were older, predominantly males, and with significantly more comorbidities. In multivariable ordered logistic regression age (OR per SD 1.54, 95% CI 1.43-1.66), BMI (OR per SD 1.18, 95% CI 1.11-1.25), hypertension (OR 1.21, 95% CI 1.05-1.40), and chronic kidney disease (OR 1.18, 95% CI 1.03-1.36) were associated with higher AVC. Statin use was also associated with higher AVC (OR 1.50, 95% CI 1.27-1.78). Higher LDL cholesterol showed stronger associations with AVC in men than women (OR 1.39, 95% CI 1.24-1.56 vs. OR 1.16, 95% CI 1.02-1.31, p for interaction=0.025). T2D severity (Hemoglobin A1c, T2D duration, and number of antidiabetic drugs) was not associated with AVC. CONCLUSION: In individuals with T2D without cardiovascular disease, AVC is prevalent in nearly half of all individuals. Higher AVC was associated with T2D-related comorbidities, but not T2D severity.