Relevance of target-organ lesions as predictors of mortality in patients with diabetes mellitus
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Data
2014-08
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Background: Patients with diabetes are in extract higher risk for fatal cardiovascular events.
Objective: To evaluate major predictors of mortality in subjects with type 2 diabetes.
Methods: A cohort of 323 individuals with type 2 diabetes from several regions of Brazil was followed for a long period.
Baseline electrocardiograms, clinical and laboratory data obtained were used to determine hazard ratios (HR) and
confidence interval (CI) related to cardiovascular and total mortality.
Results: After 9.2 years of follow-up (median), 33 subjects died (17 from cardiovascular causes). Cardiovascular mortality
was associated with male gender; smoking; prior myocardial infarction; long QTc interval; left ventricular hypertrophy;
and eGFR <60 mL/min. These factors, in addition to obesity, were predictors of total mortality. Cardiovascular mortality
was adjusted for age and gender, but remained associated with: smoking (HR = 3.8; 95% CI 1.3-11.8; p = 0.019);
prior myocardial infarction (HR = 8.5; 95% CI 1.8-39.9; p = 0.007); eGFR < 60 mL/min (HR = 9.5; 95% CI 2.7-33.7;
p = 0.001); long QTc interval (HR = 5.1; 95% CI 1.7-15.2; p = 0.004); and left ventricular hypertrophy (HR = 3.5;
95% CI 1.3-9.7; p = 0.002). Total mortality was associated with obesity (HR = 2.3; 95% CI 1.1-5.1; p = 0.030); smoking
(HR = 2.5; 95% CI 1.0-6.1; p = 0.046); prior myocardial infarction (HR = 3.1; 95% CI 1.4-6.1; p = 0.005), and long QTc
interval (HR = 3.1; 95% CI 1.4-6.1; p = 0.017).
Conclusions: Biomarkers of simple measurement, particularly those related to target-organ lesions, were predictors of
mortality in subjects with type 2 diabetes.
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Diabetes mellitus, Type 2, Type 2, Diabetes mellitus, Epidemiology, Mortality, Complications
Citação
BIANCO, Henrique Tria et al. Relevance of target-organ lesions as predictors of mortality in patients with diabetes mellitus. Arquivos Brasileiros de Cardiologia, São Paulo, v. 103, n. 4, p. 272-281, Aug. 2014.