Abstract 14470: Type 2 Diabetes and Risk of Cardiovascular Events in Peripheral Artery Disease versus Coronary Artery Disease Patients

Abstract

Introduction: The prevalence of type 2 diabetes (T2DM) is higher in peripheral artery disease (PAD) than in coronary artery disease (CAD) patients, and PAD overall confers higher cardiovascular risk than CAD. Hypothesis: We hypothesize that there is a difference in cardiovascular risk between PAD and CAD patients when analyses are stratified by the presence of T2DM. Methods: We prospectively recorded cardiovascular events over 7.6±5.0 years in 253 patients with PAD, of whom 41.9% had T2DM and in 923 patients with stable CAD, of whom 26.7% had T2DM. Four groups were analyzed: CAD patients without diabetes (CAD/T2DM-; n=677), CAD patients with T2DM (CAD/T2DM+; n=246), PAD patients without diabetes (PAD/T2DM-; n=147) and PAD patients with T2DM (PAD/T2DM+; n=106). Results: The cardiovascular event rate was lowest in CAD/T2DM- patients (40.5%). It was significantly higher in CAD/T2DM+ patients (50.2%; p=0.007), in PAD/T2DM- patients (55.2%; p<0.001), and in PAD/T2DM+ patients (67.6%; p<0,001), who in turn were at a higher risk than CAD/T2DM+ or PAD/T2DM- patients (p<0.001 and p=0.013, respectively). Further, cardiovascular risk was significantly higher in PAD/T2DM- than in CAD/T2DM+ patients (p<0.001). Cox regression analysis after multivariate adjustment confirmed that PAD versus CAD (HR=2.58 [2.12-3.15]; p<0.001) more strongly than the presence of T2DM (HR=1.55 [1.30- 1.85]; p<0.001) predicted cardiovascular events. Conclusions: We conclude that even when compared to CAD PAD confers a higher risk than T2DM. PAD patients without diabetes are at a higher risk than the extremely high risk patients with the combination of CAD and T2DM; risk is exceedingly high in PAD patients with T2DM.