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Knowing modifiable risk factors may reduce CV death in type 2 diabetes
Determining vascular calcification and modifiable risk factors for heart disease could provide patients with type 2 diabetes the insight needed to take steps toward lowering their risk of death, according to research published in Diabetes Care.
“Even among this high-risk group, known cardiovascular disease risk factors were still useful in assessing ongoing risk for mortality,” Amanda J. Cox, PhD, of Griffith University in Southport, Australia, told Endocrine Today. “Use of cholesterol-lowering medication was one factor identified to be protective against mortality.”
Amanda J. Cox
Cox and colleagues looked at 371 European-Americans who had participated in the Diabetes Heart Study at 8.2 ± 3.0 years follow-up; patients all had type 2 diabetes and coronary artery calcified plaque >1,000 using a total mass score.
The investigators compared the differences in known CVD risk factors, including those that are modifiable, between living (n=218) and deceased (n=153) participants. All-cause mortality risk was quantified using Cox proportional hazards regression models.
For the deceased, duration of type 2 diabetes was longer (P=.02) and use of cholesterol-lowering medications was reduced (P=.004) compared with the living. Vascular calcified plaque scores were associated with increased mortality risk (HR=1.31-1.63; P<.03), based on adjusted analyses.
Greater HbA1c, lipids and C-reactive protein, as well as reduced kidney function, were also associated with a 1.1- to 1.5-fold increased mortality risk (P<.03) with adjustments made for confounding factors.
“The findings from this study indicate that even among patients with type 2 diabetes identified to be at high risk of adverse outcome, modifiable risk factors exist that should be targeted for early and continued intervention,” Cox said. “Identification of multiple modifiable risk factors supports the multifactorial nature of cardiovascular — and the need for concurrent — risk reduction strategies.” — by Allegra Tiver
For More Information:
Cox can be reached at Center for Diabetes Research, Wake Forest School of Medicine, G-floor, Nutrition Building, Winston-Salem, NC 27157; email: a.cox@griffith.edu.au.
Disclosures: This work was supported by NIH grants.