460-P: Pulse Pressure Predicts Future Cardiovascular Events in Cardiovascular Disease Patients with Type 2 Diabetes

Abstract

Pulse pressure, i.e. the difference between systolic and diastolic blood pressure is a measure of arterial stiffness, which is a strong predictor of cardiovascular risk. Its impact on the risk of cardiovascular events in patients with type 2 diabetes (T2DM) is unclear and is addressed in the present study. We enrolled a large high risk cohort of 1327 patients with established cardiovascular disease (1009 patients with angiographically proven stable CAD and 318 patients with sonographically proven peripheral artery disease). T2DM was diagnosed according to ADA criteria. Prospectively, cardiovascular events were recorded over a mean follow-up period of 9.3±4.6 years. At baseline, pulse pressure was 60±17 mmHg in patients with T2DM (n=481) and 57±17 mmHg in subjects who did not have T2DM (p=0.002). During follow-up, 614 patients suffered cardiovascular events. The event rate was higher in patients with T2DM than in those who did not have diabetes (54.8% vs. 42.2% p<0.001). Pulse pressure significantly predicted cardiovascular events after multivariate adjustment including diabetes status in the total study cohort, with a standardized adjusted hazard ratio (HR) of 1.14 [1.05-1.24]; p=0.003. Importantly, pulse pressure also predicted cardiovascular events in the very high risk subgroup of cardiovascular disease patients with T2DM (HR 1.20 [1.06-1.37]; p=0.006). We conclude that pulse pressure predicts cardiovascular events in cardiovascular disease patients with T2DM. Disclosure T.Plattner: None. C.H.Saely: None. A.Vonbank: None. A.Mader: None. L.Sprenger: None. M.Maechler: None. B.Larcher: None. A.Leiherer: None. A.Muendlein: None. H.Drexel: None.