O ESCORE DE CÁLCIO NA AVALIAÇÃO DA ATEROSCLEROSE EM PACIENTES
DIABÉTICOS
Waschevicz, M.D.; Silva, C.V.; Rodrigues, P. R.
Universidade Católica de Pelotas (UCPEL) e Universidade Federal de Pelotas (UFPEL)
INTRODUÇÃO: A doença cardiovascular (DCV) é uma patologia prevalente no mundo e as taxas de
morbi-mortalidade entre diabéticos são elevadas. Assim, estabelecer em portadores de Diabetes Mellitus
(DM) o Escore de Cálcio Cardiovascular (ECC) é útil para determinar suas necessidades terapêuticas.
OBJETIVO: O presente trabalho objetiva uma revisão de literatura sobre a relevância do ECC na
investigação de placa aterosclerótica em diabéticos, otimizando as intervenções terapêuticas e reduzindo
as taxas de morbi-mortalidade.
MATERIAIS E MÉTODOS: Neste estudo, foram pesquisadas publicações que continham o ECC na
avaliação da aterosclerose em diabéticos. As bases estudadas foram UpToDate, LILACS e MedLine e os
descritores utilizados foram “coronary artery calcification on CT scanning” e “Diabetes Mellitus”. Foram
encontradas 152 referências no UpToDate, 148 no MedLine e 31 no LILACS. Dessas, 7 referências no
UpToDate, 32 no MedLine e 13 no LILACS mostraram-se pertinentes.
RESULTADOS: A partir da análise dos estudos, identificou-se que a quantificação do cálcio
coronariano em diabéticos justifica-se nos pacientes com risco cardiovascular moderado aos métodos
convencionais. Ainda, o ECC possui valor preditor independente e incremental, quando comparado aos
critérios de Framingham, podendo reclassificar um paciente de risco intermediário em alto risco,
modificando terapêutica, reduzindo eventos cardiovasculares e acarretando melhores desfechos clínicos.
CONCLUSÃO: A utilização do ECC trata-se de um método auxiliar na estratificação de risco e
determinação da terapia medicamentosa em diabéticos com risco inicial intermediário. Os indivíduos com
riscos extremos devem ser cautelosamente analisados, pois provavelmente o ECC não adicionará
benefícios, podendo ainda gerar efeitos colaterais deletérios à radiação ionizante.
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