Cardiovascular risk factors associated with acute myocardial infarction and stroke in the MADIABETES cohort
Miguel Á. Salinero-Fort, F. Javier San Andrés-Rebollo, Juan Cárdenas‐Valladolid, Manuel Méndez‐Bailón, Rosa M. Chico-Moraleja, Enrique Carrillo de Santa Pau, Isabel Jiménez‐Trujillo, I. Gómez-Campelo, Carmen de Burgos Lunar, José M. de Miguel‐Yanes, MADIABETES, Juan Carlos Abánades-Herranz, A. M. Sobrado-de Vicente-Tutor, Mar Sanz-Pascual, M. Arnalte-Barrera, S. Pulido-Fernández, E. M. Donaire-Jiménez, C. Montero-Lizana, M. Domínguez-Paniagua, P. Serrano-Simarro, Ramzi Nicolas, P. Gil-Díaz, I. Cerrada-Somolinos, R. Martín-Cano, A. Cava-Rosado, T. Mesonero-Grandes, E. Gómez-Navarro, A. Maestro-Martín, A. Muñoz-Cildoz, M. E. Calonge-García, M. Martín-Bun, P. Carreño-Freire, J. Fernández-García, A. Morán-Escudero, J. Martínez-Irazusta, E. Calvo-García, A. M. Alayeto-Sánchez, C. Reyes-Madridejos, M. J. Bedoya-Frutos, B. López-Sabater, J. Innerarity-Martínez, A. Rosillo-González, A. I. Menéndez-Fernández, F. Mata-Benjumea, Pilar Vich-Pérez, Carmen Martín-Madrazo, M. J. Gomara-Martínez, C. Bello-González, A. Pinilla-Carrasco, M. Camarero-Shelly, A. Cano-Espin, J. Castro Martin, B. de Llama-Arauz, A. de Miguel-Ballano, M. A. García-Alonso, J. N. García-Pascual, Marian González-García, C. López-Rodríguez, M. Miguel-Garzón, Marina Montero-García, S. Muñoz-Quiros-Aliaga, S. Núñez-Palomo, Olga Olmos-Carrasco, N. Pertierra-Galindo, Germán Reviriego-Jaén, P. Rius-Fortea, G. Rodríguez-Castro, J. M. San Vicente-Rodríguez, M. E. Serrano-Serrano, M. M. Zamora-Gómez, M. P. Zazo-Lázaro
Abstract
Abstract We aimed to develop two models to estimate first AMI and stroke/TIA, respectively, in type 2 diabetes mellitus patients, by applying backward elimination to the following variables: age, sex, duration of diabetes, smoking, BMI, and use of antihyperglycemic drugs, statins, and aspirin. As time-varying covariates, we analyzed blood pressure, albuminuria, lipid profile, HbA1c, retinopathy, neuropathy, and atrial fibrillation (only in stroke/TIA model). Both models were stratified by antihypertensive drugs. We evaluated 2980 patients (52.8% women; 67.3 ± 11.2 years) with 24,159 person-years of follow-up. We recorded 114 cases of AMI and 185 cases of stroke/TIA. The factors that were independently associated with first AMI were age (≥ 75 years vs. < 75 years) (p = 0.019), higher HbA1c (> 64 mmol/mol vs. < 53 mmol/mol) (p = 0.003), HDL-cholesterol (0.90–1.81 mmol/L vs. < 0.90 mmol/L) (p = 0.002), and diastolic blood pressure (65–85 mmHg vs. < 65 mmHg) (p < 0.001). The factors that were independently associated with first stroke/TIA were age (≥ 75 years vs. < 60 years) (p < 0.001), atrial fibrillation (first year after the diagnosis vs. more than one year) (p = 0.001), glomerular filtration rate (per each 15 mL/min/1.73 m 2 decrease) (p < 0.001), total cholesterol (3.88–6.46 mmol/L vs. < 3.88 mmol/L) (p < 0.001), triglycerides (per each increment of 1.13 mmol/L) (p = 0.031), albuminuria (p < 0.001), neuropathy (p = 0.01), and retinopathy (p = 0.023).