Major adverse cardiovascular events among patients with type 2 diabetes mellitus: A prospective study

Large-scale studies (UKPDS and CALIBER) reported annual major adverse cardiovascular events (MACE) rates of 2.5-2.6% occurrence in patients with type 2 diabetes mellitus (T2D). However, data for different geographical locations in Spain are unknown. The aim of this study was to investigate the most common causes of MACE and the factors that contribute to its occurrence in patients with DM2 living in southern Spain.

In this cohort study, 297 patients with T2D were monitored over 49 months to assess the occurrence of MACE (i.e., stroke, myocardial infarction, and/or cardiovascular death). Sociodemographic and clinical data (including cardiovascular disease risk factors and initial treatments) were collected to examine their impact on the incidence of MACE.

The mean age of the cohort was 67.7 years, with a male predominance (53.3%) and an average T2D duration of 8.8 years. Over the 4-year follow-up, 10.7% of patients experienced a MACE, with myocardial infarction and cardiovascular death being the most prevalent events (both 38.7%). In multivariate analysis, each additional year of T2D evolution was associated with a 15% increased risk of MACE (HR=1.150 [1.006-1.314], p=0.041), while each unit increase in estimated glomerular filtration rate (eGFR) was linked to a 3.3% risk reduction (HR=0.967 [0.938-0.997], p=0.033).

Myocardial infarction and cardiovascular death were the leading causes of MACE in T2D patients over a 4-year follow-up. Longer T2D duration and lower eGFR were the most significant risk factors. These findings underscore the need of closer monitoring and intensive treatment in patients with long-standing T2D and/or impaired renal function.