Study on the effects of different risk stratifications in patients with diabetes mellitus: a clinical endpoint event

Abstract

To estimate the relationship between the risk stratification of patients with diabetes and their clinical endpoint events. In this cohort study, we prospectively followed 8302 individuals under the following situations:contents of fasting plasma glucose ≥ 7.0 mmol/L, being diagnosed as diabetes or having used hypoglycemic drugs from Kailuan study in which 101 510 employees (81 110 males, 20 400 females, who were being employed and those retired from the company were included) from the Kailuan Company, were screened. During the 38 - 53 (48.01 ± 3.14) months of follow-up period, a new heart or cerebrovascular events were ascertained every six months. The impacts of different risk stratification in diabetic population on the incidence rates of cardiovascular and cerebrovascular events were estimated. Using the definitions of "people with ischemic cardiovascular disease incidence of 10-year risk assessment methods" developed by the Chinese Academy of Medical Sciences, Institute of Cardiovascular Disease, the study cohort was divided into four groups, namely, very low-risk, low risk, medium risk and high risk. (1) Along with the increasing risk of the disease, the incidence rates of total cardiovascular and cerebrovascular events, myocardial infarction, stroke, cardiovascular death and all-cause death rate also gradually increased and the differences were statistically significant (P < 0.01). However, the difference on incidence rate of sudden death was not significantly different (P > 0.05). (2) Compared to the very low-risk group, the age and sex adjusted relative risk for cardiovascular and cerebrovascular events were 1.42 (95%CI: 1.02 - 1.96, P < 0.05), 2.26 (95%CI: 1.67 - 3.04, P < 0.01) for those with medium and high risk groups, respectively. In diabetic patients, those risk factors as age, hypertension, body mass index, total cholesterol and smoking having been used on ischemic cardiovascular disease, could also be used to predict the occurrence of cardiovascular events. Along with the increasing risk factors, the risk of cardiovascular events incidence also increased.