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

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 m(2) 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).