Coronary artery calcification score (CACs) has been shown to be useful for assessment of cardiovascular risk in diabetic patients without known coronary artery disease. CACs can be useful to detect high risk patients (CACs>400) or low risk patients (CACs<10).

To check if CAC is discriminant to stratify the cardiovascular risk whatever the age is.

A CACs was prospectively performed in 460 consecutive type 2 diabetic patients with≥2 additional risk factors (age>50 for men and>60 for women, hypertension, current smoking, elevated LDL and albuminuria) but without any known coronary artery disease during a yearly check-up between January 2015 and December 2016.

Mean age was 61±10 [30–87] y.o. and 58% were male. Mean duration of diabetes was 15±10 years and 35% were treated with insulin for a mean duration of 10±8 years. Mean CAC score was 287±30 [0–5983]. CACs=0 was found in 25%, CACs<10 in 39%, CACs<100 in 61%, CACs>400 in 20% and CACs>1000 in 9% of the population. A significant relationship was found between CACs and duration of diabetes, waist circumference, creatinine level and GFR, albuminuria and LDL levels. CACs level was highly related to age: r=0.522, P<0.0001 (Fig. 1). Mean CACs in the different age groups, as proportion of CACs<10 or>400 are presented in Table 1. ROC curve analysis demonstrated that the threshold for detecting a high risk (CACs>400) with a sensitivity>95% was 55 y.o. In the other hand, the threshold for detecting a low risk (CACs<10) with a sensitivity>95% was 69 y.o.

From our study, in type 2 diabetic patients without known coronary artery disease, the detection of high risk individuals (CACs>400) is probably relevant after 55 y.o. and detection of low risk individuals (CACs<10) before 69 y.o. We can conclude that the more discriminant age range for performing CAC score in this population of type 2 diabetic patients without known coronary artery disease is probably 55 to 69 y.o.