1287-P: Type 2 Diabetes and Albuminuria as Predictors of Major Cardiovascular Events in Patients with Established Cardiovascular Disease

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Introduction and Objective: This study aims to investigate the single and joint effects of T2DM and albuminuria on major cardiovascular events (MACE) in patients with established cardiovascular disease (CVD).Methods: We prospectively investigated 854 patients with CVD (743 with coronary artery disease and 111 with peripheral artery disease) over 9.3±4.5 years. Albuminuria was defined as urine albumin/creatinine ratio >30 mg/gResults: MACE occurred more frequently in T2DM patients (n=253) than in non-diabetic subjects (59.7% vs 45.9%, p<0.001) and in patients with albuminuria (n=289) than in those without albuminuria (64.0% vs 42.7%, p<0.001). When both T2DM and albuminuria were considered, 432 subjects had neither T2DM nor albuminuria, 131 had T2DM but not albuminuria, 167 did not have diabetes but had albuminuria, and 124 had both T2DM and albuminuria. Compared to the incidence of MACE among patients with neither T2DM nor albuminuria (40.7%), MACE occurred more frequently in patients with T2DM who did not have albuminuria (49.2%; p=0.041) as well as in non-diabetic patients with albuminuria (59.0%; p<0.001); the incidence of MACE was highest in patients with T2DM and albuminuria (70.7%; p<0.001), in whom it was higher than in those with T2DM but not albuminuria (p<0.001) or those without T2DM but with albuminuria (p=0.001); the incidence of MACE did not differ significantly between non-diabetic patients with albuminuria and T2DM patients who did not have albuminuria (p=0.156). In Cox regression analysis, T2DM (HR 1.43 [1.11-1.85]; p=0.007) and albuminuria (HR 1.91 [1.49-2.45]; p<0.001) proved to be mutually independent predictors of MACE after multivariate adjustment for age, sex, BMI, history of smoking, hypertension, LDL-C and HDL-C.Conclusion: We conclude that T2DM and albuminuria in patients with established CVD are mutually independent predictors of MACE. CVD patients with both Albuminuria and T2DM are at an extremely high risk for MACE.

Disclosure

T. Plattner: None. A. Vonbank: None. B. Larcher: None. A. Mader: None. L. Schnetzer: None. M. Neyer: None. J. Vogel: None. P. Elsner: None. A. Leiherer: None. A. Muendlein: None. A. Festa: None. H. Drexel: None. C.H. Saely: None.



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