450-P: Impact of Prior Coronary Artery Disease (CAD)/Cerebrovascular Disease (CVD) and Diabetes Mellitus (DM) on Incident CAD/CVD in Japanese

Abstract

Although DM and prior CAD/CVD are established risk factors for subsequent CAD and CVD, which has the higher impact on future events is unclear. Moreover, few studies have evaluated combined risks of a history of CAD/CVD on subsequent events in the same cohort. Thus, we analyzed a nationwide claims-based database of 292477 people in 2008-17. Participants had either non-DM or DM based on blood tests and prescriptions (non-DM 274860, DM 17617). They were also classified as with or without prior CAD/CVD based on ICD-10 codes and questionnaire. Cox regression model showed that compared with DM(-)CAD(-), DM(+)CAD(-), DM(+)CAD(-), and DM(+)CAD(+) had 5.2(4.1-6.6), 2.6(2.3-3.0), and 8.9(6.7-11.8) times increased risk of CAD, respectively. Compared with DM(-)CVD(-), DM(-)CVD(+), DM(+)CVD(-), and DM(+)CVD(+) had 5.8(4.6-7.4), 1.4(1.2-1.6), and 5.8(4.0-8.6) times increased risk of CVD, respectively. A stratified analysis of 8 groups of combinations of DM status and prior CAD/CVD showed that those with prior CVD had a significantly increased risk of future CVD and those with prior CAD and DM(+) had a high risk of subsequent CAD (Table). This shows that prior CAD/CVD confers a far higher risk than DM status alone for future CAD/CVD. Prior CAD and DM additively increased the risk of future CAD, while prior CVD alone increased the risk of future CVD without additional effects by diabetes. Disclosure K. Fujihara: None. Y. Matsubayashi: None. M. Harada: None. T. Osawa: None. M. Yamamoto: None. M. Kitazawa: None. M. Kaneko: None. H. Seida: None. N. Yamanaka: None. S. Kodama: None. 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.