Effects of Treatment Targets on Subsequent Cardiovascular Events in Chinese Patients with Type 2 Diabetes

  1. Alice P.S. Kong, FRCP1,,2,
  2. Xilin Yang, PhD1,
  3. Gary T.C. Ko, MD (gtc_ko{at}hotmail.com)3,
  4. Wing-Yee So, FRCP2,
  5. Wing-Bun Chan, FRCP2,,4,
  6. Ronald C.W. Ma, MRCP2,
  7. Vanessa W.S. Ng, MRCP2,
  8. Chun-Chung Chow, FRCP2,
  9. Clive S. Cockram, MD2,
  10. Peter C.Y. Tong, PhD2,
  11. Vivian Wong, MD5 and
  12. Juliana C.N. Chan, MD2
  1. 1Li Ka Shing Institute of Health Sciences
  2. 2Department of Medicine and Therapeutics
  3. 3Alice Ho ML Nethersole Hospital
  4. 4Qualigenics Diabetes Centre, The Chinese University of Hong Kong
  5. 5Hospital Authority, Hong Kong

    Abstract

    Abstract Objective - International guidelines recommend optimal control of risk factors in diabetes to prevent cardiovascular events. We examined risk associations between achieving treatment targets for glycemia, blood pressure and lipid control, and other risk factors on subsequent cardiovascular events in Chinese patients with type 2 diabetes.

    Abstract research design and Methods - Between 1995 and 2005, 6386 Chinese type 2 diabetes without history of coronary heart disease (CHD) or stroke were recruited. They were classified according to the number of treatment targets attained at baseline and their cardiovascular outcomes were compared. Treatment targets were defined as glycated hemoglobin (HbA1c) <7.0%, blood pressure <130/80 mmHg and low-density lipoprotein cholesterol (LDL-C) <2.6 mmol/L.

    Abstract Results - After a median follow-up of 5.7 years, cumulative incidence of CHD or stroke [n=749] increased with decreasing numbers of treatment targets attained at baseline. Attainment of two or more targets at baseline was associated with reduced risk of CHD compared to those with no target achieved (hazard ratio, HR [95% CI] = 0.69 [0.50-0.94], p=0.020). However, the association lost its significance after adjustment for urinary albumin creatinine ratio, estimated glomerular filtration rate and haemoglobin.

    Abstract Conclusions - Reaching more treatment targets was associated with reduced risk of new onset of CHD in Chinese patients with type 2 diabetes.

    Footnotes

      • Received November 30, 2006.
      • Accepted January 11, 2007.

    This Article

    1. Published online before print January 26, 2007, doi: 10.2337/dc06-2443
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