PREDICTORS OF MORTALITY AND CARDIOVASCULAR EVENTS IN PATIENTS NEWLY DIAGNOSED WITH TYPE 2 DIABETES MELLITUS

Author(s)

Hunter TM, Alatorre CI, Hoogwerf B, Deeg M, Nelson D, Jiang D, Rekhter M
Eli Lilly and Company, Indianapolis, IN, USA

OBJECTIVES: The study aim was to identify risk factors associated with cardiovascular (CV) events or all-cause mortality in newly-diagnosed type 2 diabetes (T2DM) patients without recent history of CV events and who rapidly achieve and maintained glycated hemoglobin (HbA1c) ≤8.0%.  METHODS: Data were obtained from the Clinical Practice Research Datalink from January 1990 to December 2012. A nested case-control design was used and survival analyses were conducted. The primary endpoints were time to CV event or to death. For each outcome, Cox proportional hazards models were built using a backward selection procedure with p>0.05 as the exclusion criteria. RESULTS: Of the 350,138 newly diagnosed T2DM patients, 11,426 met the criteria for cases and 70,725 for controls. In the case cohort, death was the main outcome, affecting 53.96% of patients over 23 years. Increasing age, male gender, and increasing Charlson Comorbidity Index was associated with a significant risk of CV event or death. Glucose control (6.0% ≤HbA <7.0%) was associated with reduced risk of CV event or death; hyperglycemia (HbA ≥7.5%) was associated with increased risk. Increasing number of oral antihyperglycemic or concomitant medications, increasing white blood cells, diagnosis of depression or anxiety, and nitrate use at baseline were associated with an increased risk of CV event or death. The use of anti-inflammatory medications, beta blockers, calcium channel blockers, and statins were associated with reduced risk of death but did not significantly impact the risk of CV events.  An index year between 2000 and 2012 was associated with a reduced risk of CV event, while only the period between 2010 and 2012 was associated with a reduced risk of death.  CONCLUSIONS: These results suggest that early and sustained glycemic control is an important modifiable risk factor that is associated with reduced risk of CV events and death in newly-diagnosed T2DM patients.

Conference/Value in Health Info

2016-05, ISPOR 2016, Washington DC, USA

Value in Health, Vol. 19, No. 3 (May 2016)

Code

PDB20

Topic

Clinical Outcomes

Topic Subcategory

Relating Intermediate to Long-term Outcomes

Disease

Diabetes/Endocrine/Metabolic Disorders

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