2209-PUB: Type 2 Diabetes and Different Manifestations of Preexisting Cardiovascular Disease as Predictors of Specific Cardiovascular Events

Abstract

Coronary artery disease (CAD) and peripheral artery disease (PAD) confer an increased risk of cardiovascular events that is particularly high when type 2 diabetes (T2DM) is present in addition to cardiovascular disease (CVD). Here, we aimed at investigating the impact of T2DM and of the manifestation of pre-existing cardiovascular disease (PAD vs. CAD) as predictors of specific cardiovascular events. We prospectively recorded cardiovascular events over 10 years in 1777 patients with established CVD, including 1312 patients with CAD, of whom 29.3% had T2DM and 465 patients with PAD, of whom 43.9% had T2DM. T2DM after multivariate adjustment significantly predicted cardiovascular mortality (n=102; HR 1.77 [1.33-2.36]; p<0.001), myocardial infarction (n=74; HR 1.50 [1.10-2.04]; p=0.010), ischemic stroke (n=54; HR 1.69 [1.16-2.46]; p=0.007), and revascularization of non-coronary arteries (n=134; HR 1.66 [1.29-2.13]; p<0.001) independently from the manifestation of CVD. The presence of PAD versus that of CAD after adjustment for conventional cardiovascular risk factors including T2DM predicted myocardial infarction (HR 2.33 [1.61-3.37]; p<0.001) and revascularization of non-coronary arteries (HR 7.48 [5.51-10.16]; p<0.001). Neither T2DM nor the presence of PAD vs. that of CAD was significantly associated with percutaneous coronary interventions (n=246) or coronary artery bypass graftings (n=94) in our cohort. We conclude that both T2DM and the manifestation of pre-existing CVD predict cardiovascular events in patients with established CVD. Disclosure C.H. Saely: None. A. Vonbank: None. C. Heinzle: None. D. Zanolin-Purin: None. B. Larcher: None. A. Mader: None. S. Sternbauer: None. M. Schindewolf: None. I. Baumgartner: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None.