Carotid intima-media thickness progression predicts cardiovascular events in Japanese patients with type 2 diabetes

• Published in: Diabetes research and clinical practice Vol. 101; no. 3; pp. 286 - 292
• Main Authors: Okayama, Kaede Ishikawa, Mita, Tomoya, Gosho, Masahiko, Yamamoto, Risako, Yoshida, Michiko, Kanazawa, Akio, Kawamori, Ryuzo, Fujitani, Yoshio, Watada, Hirotaka
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.09.2013
• Subjects: Asian Continental Ancestry Group; Cardiovascular and cerebrovascular events; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - etiology; Carotid Intima-Media Thickness; Cerebrovascular Disorders - diagnosis; Cerebrovascular Disorders - etiology; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - physiopathology; Endocrinology & Metabolism; Humans; Intima-media thickness; Multivariate Analysis; Proportional Hazards Models; Intima-media thickness; Cardiovascular and cerebrovascular events; Diabetes mellitus
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2013.06.008

Abstract Aims The aim of this retrospective study was to investigate the relationship between progression of carotid intima-media thickness (cIMT) and cardiovascular events in Japanese patients with type 2 diabetes mellitus (T2DM) and free of history of cardiovascular events. Methods Patients with T2DM ( n = 342) without history of cardiovascular events whose cIMT was assessed more than twice by ultrasonography were recruited and followed up for cardiovascular events. Results During a mean follow-up of 7.6 years, 56 (16.4%) cardiovascular events (27 coronary events and 29 cerebrovascular events) were recorded. Multivariate analysis with the Cox proportional hazard model identified cIMT progression as a significant determinant of cardiovascular events, with a hazard ratio (HR) of 2.24 (95% confidence interval; CI, 1.25–4.03, P < 0.01), in addition to baseline cIMT. The Kaplan–Meier curves also showed significantly higher event rate in patients with high cIMT progression compared with those with low cIMT progression (log-rank χ2 = 6.65; P < 0.01). Furthermore, the combination of high baseline cIMT and high cIMT progression was a significant predictor of cardiovascular events. Conclusion Our findings suggest that cIMT progression, in addition to baseline cIMT, is a predictor of cardiovascular events in patients with T2DM without history of cardiovascular events, and that the combination of cIMT progression and baseline cIMT has a strong predictive power for such events.