Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2007;60:251-8 - Vol. 60 Num.03 DOI: 10.1016/S1885-5857(07)60149-2

Factors Predictive of Cardiovascular Disease in Patients With Type-2 Diabetes and Hypercholesterolemia. ESODIAH Study

Xavier Pintó a, Emili Corbella a, Rosaura Figueras a, Josefina Biarnés b, Wifredo Ricart b, Clotilde Morales c, Liliana Falkon d, Luis Masana e

a Unidad de Lípidos, Servicio de Medicina Interna, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España,
b Servicio de Endocrinología, Hospital de Girona Dr, Josep Trueta, Girona, España,
c Unidad de Lípidos, Servicio de Medicina Interna, Hospital General de Manresa, Manresa, Barcelona, España,
d Departamento Médico, Lácer, S,A, Barcelona, España,
e Unidad de Lípidos, Servicio de Medicina Interna, Hospital Sant Joan, Reus, Tarragona, España,

Keywords

Diabetes mellitus. Cardiovascular disease. Hypercholesterolemia. Cardiovascular risk factors. Follow-up studies.

Abstract

Introduction and objectives. We investigated the pattern of cardiovascular disease and the factors that predict such disease in outpatients with type-2 diabetes and hypercholesterolemia. Methods. This prospective open observational study included outpatients of both sexes (mean age 62 [8] years) with type-2 diabetes and hypercholesterolemia. Clinical manifestations of cardiovascular disease (e.g., angina, myocardial infarction, stroke and peripheral arterial disease), glucose and HbA1c levels, and cardiovascular risk factors were recorded every 4 months throughout the 2-year follow-up period. Overall, 838 patients completed follow-up. Results. During follow-up, 81 patients (9.6%) presented with a cardiovascular event, nine of which were fatal. Cardiovascular events were more frequent in patients with a history of an ischemic condition than in those without: 58 of 258 (22.5%) and 23 of 579 (4%), respectively (P<.01). Previous angina or myocardial infarction was the strongest predictor of cardiovascular risk (relative risk [RR]=4.08, 95% confidence interval [CI] 2.39-6.95), followed by previous stroke (RR=2.96, 95% CI 1.26-6.93), high low-density lipoprotein (LDL)-cholesterol level ≥135 mg/dL (RR=2.79, 95% CI 1.56-5.01), peripheral arterial disease (RR=2.44, 95% CI 1.27-4.68), a high HbA1c level (RR=2.08, 95% CI 1.22-3.57), and obesity (RR=1.69, 95% CI 1.0-2.86). Conclusions. The incidence of cardiovascular disease in this southern European population of patients with type-2 diabetes and hypercholesterolemia was high. A history of an ischemic condition and a high LDL-cholesterol level during follow-up were the strongest predictors of cardiovascular disease.

1885-5857/© 2007 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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