Risk factors and rates of fatal cardiovascular events in patients with extreme and very high risk type 2 diabetes mellitus

• Oksana D. Rymar
• Liliya V. Shcherbakova
• Svetlana V. Mustafina
• Galina I. Simonova
• Ekaterina M. Avdeeva
• Yuliya A. Dolinskaya
• Sofiya K. Malyutina

Abstract

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Only a personalized, integrated approach to risk factors (RF) and treatment can improve prognosis and reduce mortality in people with T2DM.

The aim of the study was to investigate the frequency of fatal CV events and to analyze RF in people with T2DM based on cohort observation data.

Material and methods. Prospective follow-up of 384 residents of Novosibirsk with a diagnosis of T2DM was performed: the mean age was 61.3±6.3 years. The baseline survey was carried out within the framework of the HAPIEE project in 2003–2005. The group with a history of major CVD included 70 people, the group without a history of CVD consisted of 314 people. Anthropometry, systolic blood pressure (SBP), diastolic blood pressure (DBP), some biochemical parameters, socio-demographic data were determined. As part of a prospective follow-up of people with T2DM, an analysis of the frequency of fatal CV events that occurred after the baseline examination and until December 2013 was made. CV death was established in accordance with the codes of the International Classification of Diseases 10th revision (ICD-10).

Results and discussion. In both groups, the studied indicators of waist circumference (WC), body mass index, SBP, DBP, blood lipids, fasting plasma glucose (FPG) were comparable and, on average, higher than the target values for this category of patients. A high comparable frequency of CVD risk factors in the studied groups was also revealed. In total, during the 10-year follow-up period, 25.7% had fatal CV events among people with T2DM who had CVD at baseline, and 15.9% among people without baseline CVD.

Conclusion. Among people with T2DM with a history of CVD over a 10-year follow-up period, fatal CV events occurred 1.6 times more often than among people without baseline CVD. The obtained data confirm the importance of primary prevention of CVD diseases in patients with T2DM.

Keywords:type 2 diabetes mellitus; cardiovascular risk; cardiovascular death

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