437-P: Coronary Calcium Score and Cardiovascular Events in Ketosis-Prone Diabetes Compared with T2DM

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Introduction and Objective: Coronary artery calcium score (CACS) is an effective marker to stratify cardiovascular risk. Compared to type 2 diabetes (T2D) Ketosis Prone Diabetes (KPD) has an atypical presentation marked by ketosis during decompensation. We compared CACS and cardiovascular events (CVE) in KPD and T2D. Methods: It is a retrospective observational study (2014-2024) of KPD and T2D patients attending the diabetology day hospital and undergoing CACS evaluation. We recorded CVE occurring after CACS evaluation: non-fatal myocardial infarction (MI), coronary revascularization (CR), heart failure (HF), obliterative arteriopathy of the lower limbs (OA). Results: A total of 1244 patients (106 KPD and 1138 T2DM) were included in the analysis. Their characteristics are presented in Table 1. In the study population, 66.8% had CACS <100 and 16.2% >400. Median KPD CACS compared to T2D was lower (p<0.0001). Percentage of KPD with CACS <100 was higher and CACS >400 lower compared to T2D (p=0.001). Odds ratio (OR) for CACS <400 was 5 times higher for KPD 5.37 (1.95 - 14.75, p<0.0001) (95% CI). In multivariate logistic regression, OA, limb amputation and albumin/creatinine ratio (ACR) were significantly associated to CACS >400 (p<0.05) Conclusion: KPD showed lower CACS and lower frequency of OA occurrence compared to T2D. However recorded MI were similar in both groups. Disclosure J. Nguewa: None. J. Kevorkian: None. J. Julla: Other Relationship; Lilly Diabetes. Board Member; Sanofi. Other Relationship; Novo Nordisk. F. Féron: None. M. Laloi-Michelin: None. L. Akl: None. R. Badawi: None. K. Chafai: None. J. Riveline: Consultant; Abbott, Lilly Diabetes, Novo Nordisk, Sanofi, Dexcom, Inc., Air Liquide, Insulet Corporation. Research Support; Tandem Diabetes Care, Inc, Juvenile Diabetes Research Foundation (JDRF). J. Gautier: Board Member; Sanofi. Advisory Panel; Pfizer Inc, Novo Nordisk. Other Relationship; Eli Lilly and Company.

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