Cardiovascular risk factors associated with acute myocardial infarction and stroke in the MADIABETES cohort

Abstract

We aimed to develop two models to estimate first AMI and stroke/TIA, respectively, in type 2 diabetes mellitus patients, by applying backward elimination to the following variables: age, sex, duration of diabetes, smoking, BMI, and use of antihyperglycemic drugs, statins, and aspirin. As time-varying covariates, we analyzed blood pressure, albuminuria, lipid profile, HbA1c, retinopathy, neuropathy, and atrial fibrillation (only in stroke/TIA model). Both models were stratified by antihypertensive drugs. We evaluated 2980 patients (52.8% women; 67.3 ± 11.2 years) with 24,159 person-years of follow-up. We recorded 114 cases of AMI and 185 cases of stroke/TIA. The factors that were independently associated with first AMI were age (≥ 75 years vs. < 75 years) (p = 0.019), higher HbA1c (> 64 mmol/mol vs. < 53 mmol/mol) (p = 0.003), HDL-cholesterol (0.90–1.81 mmol/L vs. < 0.90 mmol/L) (p = 0.002), and diastolic blood pressure (65–85 mmHg vs. < 65 mmHg) (p < 0.001). The factors that were independently associated with first stroke/TIA were age (≥ 75 years vs. < 60 years) (p < 0.001), atrial fibrillation (first year after the diagnosis vs. more than one year) (p = 0.001), glomerular filtration rate (per each 15 mL/min/1.73 m2 decrease) (p < 0.001), total cholesterol (3.88–6.46 mmol/L vs. < 3.88 mmol/L) (p < 0.001), triglycerides (per each increment of 1.13 mmol/L) (p = 0.031), albuminuria (p < 0.001), neuropathy (p = 0.01), and retinopathy (p = 0.023).

Influencing factors of stroke in patients with type 2 diabetes: A systematic review and meta-analysis

“…The meta-analysis encompassed 22 influencing factors categorized into sociodemographic factors, biochemical factors, complications, and hypoglycemic agents. Among the sociodemographic factors are age [ 15 – 26 ], gender [ 15 , 17 , 20 , 27 – 28 ], course of T2DM [ 15 , 20 , 23 , 29 , 31 ], hypertension [ 15 , 20 – 22 , 28 , 30 , 32 – 35 ], BMI [ 15 , 19 – 20 , 33 ], smoking [ 15 , 17 , 24 , 29 , 33 , 36 ] and exercise [ 29 , 33 , 36 ]; Biochemical indexes are HbA1c [ 15 , 17 , 22 , 30 , 37 ], eGFR [ 16 , 19 , 22 , 38 – 39 ], TC [ 16 , 25 , 30 – 31 ], TG [ 16 , 19 , 24 ], Albuminuria [ 16 , 31 , 40 ...…”

“…In addition to the factors noted above, several variables have shown significant associations with stroke occurrences in patients with T2DM. These factors include central obesity [ 25 ] (2.07, 95% CI: 1.39–3.09), inadequate sleep duration [ 33 ] (< 6h/ day: 1.44, 95% CI: 1.20–1.73; > 8h/ day: 1.22, 95% CI: 1.05–1.42), obstructive sleep apnea [ 54 ] (1.57, 95% CI: 1.27–1.94), lower educational attainment [ 28 ] (2.60, 95% CI: 1.20–5.80), alcohol misuse [ 24 ] (2.60, 95% CI: 1.20–5.80), degree of cerebral artery stenosis [ 32 ] (4.77, 95% CI: 2.60–9.81), diabetic neuropathy [ 16 ] (1.73, 95% CI: 1.14–2.64), congestive heart failure [ 18 ] (2.08, 95% CI: 1.26–3.42), and SU [ 55 ] (as compared to MET: 3.23, 95% CI: 3.01–3.45). Furthermore, Free triiodothyronine [ 32 ] (0.36, 95% CI: 0.20–0.64), SGLT2-i [ 56 ] (0.85, 95% CI: 0.82–0.88), and GLP-1RA [ 57 ] (0.82, 95% CI: 0.74–0.91) have demonstrated negative correlations.…”

“…The meta-analysis encompassed 22 influencing factors categorized into sociodemographic factors, biochemical factors, complications, and hypoglycemic agents. Among the sociodemographic factors are age [15][16][17][18][19][20][21][22][23][24][25][26], gender [15,17,20,[27][28], course of T2DM [15,20,23,29,31], hypertension [15,[20][21][22]28,30,[32][33][34][35], BMI [15,[19][20]33], smoking [15,17,24,29,33,36] and exercise [29,33,36]; Biochemical indexes are HbA1c [15,17,22,30,…”

Factores asociados a infarto agudo del miocardio en usuarios de un programa de rehabilitación cardiovascular

“…respectivamente), además fumar (12,97 %) y el consumo de alcohol (5,46 %) (9). Estos hallazgos son similares a los de Salinero et al (11), quienes identificaron como factores asociados al primer iam ser mayor de 75 años, el colesterol hdl (0,90-1,81 mmol) y presión arterial sistólica de 65-85 mm Hg (10), a lo que se suma el consumo de tabaco de segunda mano (or 3,1 ic 1,2-3,7) y el sedentarismo (or 2,5 ic 1,0-3,5). Con relación al sexo, los resultados de este estudio coinciden con los de Sáenz Campos et al (12), donde el masculino fue predominante, con datos similares en la edad, el peso, el imc, adicional a presentar el hábito de consumo de tabaco y ser diabéticos; por otro lado, Castellanos Rojas et al (13) explican que el sexo femenino no es un factor de riego antes de los 50 años, por contar con la protección estrogénica durante el periodo de vida fértil.…”

Analysis of the Association between Retinal Artery Occlusion and Acute Ischaemic Stroke/ST-Elevation Myocardial Infarction and Risk Factors in Hungarian Patients

“…The pathogenetic role of age in ischaemic stroke was demonstrated by Salinero-Fort and colleagues. Their study in a Mediterranean population of RAO patients revealed age to be the only independent factor in the development of cardio/cerebrovascular events [ 26 , 27 ].…”