2144-PUB: Elevated Carotid Intima-Media Thickness Is an Important Predictor of Major Cardiovascular Events and All-Cause Death in Elderly Women with Diabetes

Abstract

Background and Aims: The presence of diabetes mellitus (DM) is associated with unfavorable long-term outcomes. The aim of this study was to assess the risk factors of clinically significant end points associated with the presence of diabetes in the 6.5-year follow-up of a group of elderly women. Material and Methods: A group of 364 women aged 65-74 (98 with DM) were included in the study in 2012. After 6.5 years of follow-up we evaluated risk factors (anthropometric, metabolic and clinical, including carotid intima/media thickness - CIMT) associated with the occurrence of composite major cardiovascular (CV) event (MACE) (non-fatal myocardial infarction [MI], non-fatal stroke or CV death), and all-cause death depending on the baseline presence of DM. Results: During follow-up MACE occurred in 26 women (12 with DM) and 40 females died (15 with DM). Survival data were available for all 364 women, while MACE data for 290. Baseline DM was associated with significantly higher relative risk (RR) of MACE, RR 1.69 (95% CI 1.07-2.68), P=0.043, and CV death, RR 2.53 (1.65-3.89), P=0.004. In a group with DM older age, higher CIMT and history of CV event were associated with both MACE and all-cause death. We established the best cut-off point for CIMT at 1.2 mm. Women with CIMT ≥1,2 mm had significantly higher risk of MACE, RR 5,13 (1.85-14.27), P=0.003, and of all-cause death, RR 6.24 (2.53-15.39), P<0.001, compared to those with lower CIMT. In the multiple logistic regression analysis significant predictors of MACE were both CIMT ≥1,2 mm, RR 5.09 (1.15-22,57), P=0.032 and history of MI or stroke, RR 5.47 (1.10-27.07), P=0.037, while CIMT ≥1,2 mm was the only independent predictor of all-cause death, RR 7,29 (1,99-26,67), P=0.003. Conclusions: CIMT ≥1.2 mm seem to be an important predictor of MACE and the best predictor of all-cause death in elderly women with diabetes. Thus, CIMT assessment can be useful in identifying persons at very high risk of these outcomes. Disclosure M. Dabrowski: Other Relationship; Self; Ascensia Diabetes Care, AstraZeneca, Berlin-Chemie AG, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Mundipharma International, Novo Nordisk Inc., Sanofi-Aventis, Servier. T. Derezinski: None. A. Uruska: None. D. Zozulinska-Ziolkiewicz: None.