Factors associated with long-term adverse cardiovascular events in patients with type 2 diabetes

Abstract

Aim. To identify factors associated with long-term adverse cardiovascular events (CVEs) in patients with type 2 diabetes (T2D).Material and methods. The study included 94 T2D patients aged 40 to 65 years with or without early symptoms of heart failure (HF). Patients underwent clinical and laboratory investigations, 6-minute walk test (6MWT), and echocardiography. Concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP) was determined. After 8,8±0,72 years of follow-up, the prevalence of following CVEs among patients were assessed: any-cause death, myocardial infarction, stroke, emergency myocardial revascularization, hospitalization due to decompensated HF. We assessed the relationship between the development of long-term CVEs in T2D patients and the initial characteristics using logistic regression model.Results. Over a period of 8,8±0,72 years, CVEs occurred in 34 out of 88 (38,6%) patients with T2D. The baseline 6MWT values were lower in patients with CVEs (391,8±56,2 m vs 418,8±53,9 m, p=0,04). Stable coronary artery disease (55,9% vs 27,8%, p=0,008), early-stage HF (61,8% vs 27,8%; p=0,0016) were more common among patients with CVEs. Patients with CVEs had higher median initial NT-proBNP (46,9 pg/ml vs 24,2 pg/ml, p=0,01) and mean left atrial (LA) size (4,5±0,6 cm vs 4,19±0,5 cm, p=0,04) levels. The logistic regression established following factors associated with long-term CVEs in patients with T2D: NT-proBNP level (p=0,05), LA size (p=0,01), and 6MWT results (p=0,002).Conclusion. The development of long-term CVEs in middle-aged T2D patients with or without early-stage HF is associated with an initially increased NT-proBNP levels, an increase in left atrial size, and a decrease in 6MWT values. Further prospective studies with larger samples are needed to identify other factors affecting outcome in patients with early signs of HF.