448-P: Predictors and Their Impact on Coronary Artery Disease (CAD) According to Glucose Tolerance Status (GTS) and Prior CAD: Historical Cohort Study in Japan

Abstract

Although GTS, prior CAD and other traditional risk factors independently affect incidence of subsequent CAD, their impact in the same cohort has been scantly studied. We analyzed a nationwide claims-based database of 138,162 men aged 18-72 y in 2008-14. Participants were classified as normal glucose tolerance (NGT, n=78,230), prediabetes (PreDM, n=45,610) or diabetes mellitus (DM, n=14,322) based on blood tests and prescriptions and with prior (CAD+) or without prior CAD (CAD-) based on ICD-10 codes and questionnaires. Among CAD-, management of traditional risks differed from those with and without CAD events, while such differences were weaker in preDM and DM with CAD+. Cox regression model showed that PreDM and DM confer approximately 1.2- and 2.8-fold excess risk of CAD, respectively, compared with CVD- with NGT. CAD+ confers approximately a 5- to 8-fold increased risk. Most traditional risks were independently associated with subsequent CAD in the CAD- group regardless of GTS. Conversely, in the CAD+ group, their impact was weakened and only HDL-C was a significant risk factor for future CAD in those with DM and CAD+ (Table). Thus, the impact of known risks on subsequent CAD differs markedly according to GTS and CAD+. Those with CAD+ and glucose abnormality, especially DM, need treatment residual risk factors as well as traditional risk factors. Disclosure M. Kitazawa: None. K. Fujihara: None. T. Osawa: None. M. Yamamoto: None. M. Harada: None. M. Kaneko: None. Y. Matsubayashi: None. T. Yamada: None. N. Yamanaka: None. H. Seida: None. W. Ogawa: Consultant; Self; Abbott. Research Support; Self; Astellas Pharma Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Lilly Diabetes, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi, Sumitomo Dainippon Pharma Co., Ltd. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.