Incidence of Coronary Heart Disease in Type 2 Diabetic Men and Women
Impact of microvascular complications, treatment, and geographic location
Article Figures & Tables
Figures
- Figure 1—
Independent predictors of incident CHD in diabetic men (black) and women (red). Hazard ratios are calculated for the indicated increments in the value of the variable.
Tables
- Table 1—
Age-standardized incidence rates of first CHD event in diabetic men and women according to the presence of microvascular complications in women
Men (n = 5,612) Women (n =6,032) n All (13,837)* Without microvascular complications (9,039)* With microvascular complications (4,797)* Relative risk (95% CI)† n All (15,232)* Without microvascular complications (10,177)* With microvascular complications (5,055)* Relative risk (95% CI)† All CHD 449 28.8 (25.4–32.2) 25.5 (21.6–29.5) 34.9 (28.4–41.5) 1.3 (1.1–1.6) 432 23.3 (20.2–26.4) 19.1 (15.9–22.3) 32.9 (25.5–40.3) 1.5 (1.2–1.7) AMI 164 10.3 (8.3–12.3) 8.9 (6.6–11.3) 13.4 (9.3–17.4) 1.6 (1.2–2.2) 88 4.7 (3.3–6.1) 3.3 (2.1–4.6) 7.1 (3.9–10.4) 1.9 (1.2–2.8) Non-AMI CHD 285 18.5 (15.8–21.3) 16.6 (13.5- 19.8) 21.6 (16.4–26.8) 1.2 (0.9–1.5) 344 18.6 (15.9–21.4) 15.8 (12.9–18.7) 25.8 (19.1–32.5) 1.4 (1.1–1.7) Major CHD 208 13.1 (10.9–15.4) 11.4 (8.6–14.2) 16.5 (12.2–20.8) 1.6 (1.2–2.1) 114 5.8 (4.3–7.2) 4.4 (3.1–5.8) 8.2 (4.8–11.5) 1.5 (1.0–2.2) Fatal CHD 38 2.6 (1.6–3.5) 1.8 (0.8–2.8) 3.7 (2.1–5.4) 2.6 (1.4–5.1) 14 0.6 (0.3–0.9) 0.4 (0.1–0.8) 0.9 (0.3–1.6) 2.3 (0.8–6.5) - Table 2—
Clinical characteristics of type 2 diabetic patients according to incident coronary events
Men Women Without event With event P Without event With event P n 5,163 449 5,600 432 Age at visit (years)* 64 ± 0.2 66 ± 0.8 <0.001 66 ± 0.2 68 ± 0.7 <0.001 BMI (kg/m2)* 28 ± 0.1 28 ± 0.4 29 ± 0.1 29 ± 0.5 Waist girth (cm)* 100 ± 0.3 101 ± 1.1 96 ± 0.4 97 ± 1.2 Total cholesterol (mg/dl)* 207 ± 1.3 211 ± 3.8 220 ± 1.1 221 ± 4.1 HDL cholesterol (mg/dl)* 48 ± 0.4 48 ± 1.3 52 ± 0.4 51 ± 1.4 LDL cholesterol (mg/dl)* 131 ± 1.0 134 ± 3.4 139 ± 1.0 138 ± 3.9 Duration of diabetes (years)† 7 9 <0.001 8 10 <0.001 Systolic blood pressure (mmHg)† 140 145 150 145 Diastolic blood pressure (mmHg)† 80 80 80 80 Fasting plasma glucose (mg/dl)† 153 159 158 161 Triglycerides (mg/dl)† 127 129 133 143 <0.01 Hypertension‡ 78.8 ± 1.1 87.0 ± 3.2 <0.001 86.0 ± 0.9 90.3 ± 2.9 <0.05 A1C (%)‡§ 20–50‡ 28.8 ± 1.3 31.2 ± 4.4 31.5 ± 1.3 32.2 ± 4.5 >50‡ 12.4 ± 0.9 14.4 ± 3.3 15.9 ± 1.0 17.7 ± 3.7 Alcohol intake‡ 58.2 ± 1.4 59.2 ± 4.6 21.1 ± 1.1 18.3 ± 3.7 Smoking habits‡ Never‡ 48.0 ± 1.4 44.1 ± 4.7 87.3 ± 0.9 88.4 ± 3.1 Current‡ 21.2 ± 1.1 20.3 ± 3.8 7.5 ± 0.7 7.6 ± 2.6 Former‡ 30.8 ± 1.3 35.6 ± 4.5 5.2 ± 0.6 3.9 ± 1.9 Familiarity for CVD‡ 25.7 ± 1.2 23.4 ± 4.0 30.0 ± 1.2 30.8 ± 4.4 Microvascular complications‡ 34.4 ± 1.3 42.1 ± 4.7 <0.01 32.8 ± 1.3 43.3 ± 4.8 <0.001 Antidiabetes treatment‡ Diet‡ 19.0 ± 1.1 14.3 ± 3.3 14.2 ± 0.9 11.3 ± 3.1 OHA‡ 67.4 ± 1.3 67.5 ± 4.4 67.5 ± 1.3 62.3 ± 4.7 OHA + insulin‡ 5.4 ± 0.6 8.9 ± 2.7 <0.01 8.9 ± 0.8 11.1 ± 3.0 <0.001 Insulin‡ 8.2 ± 0.8 9.4 ± 2.7 9.4 ± 0.8 15.3 ± 3.5 Lipid-lowering treatment‡ None 90.1 ± 0.8 89.3 ± 2.9 83.1 ± 1.0 78.7 ± 3.9 Statins 5.8 ± 0.6 6.5 ± 2.3 11.7 ± 0.9 13.9 ± 3.3 Fibrates 3.3 ± 0.5 4.0 ± 1.9 4.2 ± 0.5 5.6 ± 2.2 Statins + fibrates‡ 0.2 ± 0.1 — 0.2 ± 0.1 0.4 ± 0.7 Other 0.7 ± 0.2 0.2 ± 0.4 0.8 ± 0.2 1.4 ± 1.1 Geographic area‡ North‡ 56.6 ± 1.4 62.1 ± 4.6 49.5 ± 1.3 48.6 ± 4.8 Center‡ 10.5 ± 0.9 11.4 ± 3.0 <0.05 10.9 ± 0.8 11.1 ± 3.0 South and islands‡ 32.9 ± 1.3 26.5 ± 4.2 39.5 ± 1.3 40.3 ± 4.7 -
Data are
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↵* mean ±2 SE,
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↵† median, or
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↵‡ percent ±2 SE.
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↵§ Proportion of patients with A1C values above the unit-based upper limit of normal by the indicated percentage. Such upper limit was between 5.5 and 6.4% in ∼70% of the centers; the mean was 6.1%. The mean A1C level was 7.4 in women and 7.1% in men.
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In this Issue
May 2007, 30(5)
Incidence of Coronary Heart Disease in Type 2 Diabetic Men and Women
