Cardiovascular risk factors as predictors of mortality in type II diabetic patients

Mortality among diabetic patients is high and attempts have been made to find clinical markers which would help to identify patients at risk.

The purpose of this study was to assess whether cardiovascular risk factors like previous myocardial infarction, left ventricular dysfunction, hypertension, renal insufficiency, and 24-hour mean or minimum heart rate, significantly contribute to the mortality in this group of patients.

45 male patients with type II diabetes mellitus were studied by ambulatory electrocardiography to obtain the information about the 24-hour mean and minimum heart rates; records from baseline hospitalization were reviewed for clinical variables. After 55 months mortality data were retrieved. Cox's proportional hazards regression model was used to study the effect of clinical variables on mortality in multivariate analysis.

All-cause mortality was 38%. The groups of survivors and nonsurvivors differed significantly in terms of age, the presence of left ventricular dysfunction and renal insufficiency. No significant difference in 24-hour mean or minimum heart rate was registered. In the Cox's model, the presence of left ventricular dysfunction, renal insufficiency and age significantly and independently predicted mortality.

The present study, showed that left ventricular dysfunction and renal insufficiency were related to the all-cause mortality of type II diabetic patients independently of age, after 55 months of follow-up. Prognostic significance of 24-hour mean or minimum heart rate has not been proven.