DIABETES AND CARDIOVASCULAR DISEASE ARE EQUALLY STRONG PREDICTORS OF CARDIOVASCULAR EVENTS IN...

Prevention

A1395JACC April 1, 2014

Volume 63, Issue 12

diAbetes And cArdiovAsculAr diseAse Are eQuAlly strong predictors oF cArdiovAsculAr events in pAtients witH end-stAge renAl diseAse

Poster ContributionsHall CSunday, March 30, 2014, 9:45 a.m.-10:30 a.m.

Session Title: Prevention: Familial Hypercholesterolemia, Novel Therapies and Cardiovascular RiskAbstract Category: 20. Prevention: ClinicalPresentation Number: 1183-152

Authors: Luis Henrique Wolff Gowdak, Flavio de Paula, Luiz Antonio Machado Cesar, Jose Jayme G. De Lima, Heart Institute (InCor), Sao Paulo, Brazil

background: Patients (pt) with chronic kidney disease (CKD) stage V are at high risk for major adverse cardiovascular events (MACE). We sought to determine the impact of diabetes (DM) and the presence of overt cardiovascular disease (CVD) on the long-term occurrence of MACE in pt with CKD stage V.

methods: 1,516 pt with CKD stage V (61% men, 54±10 years, 40% with DM, and 39% with CVD) were prospectively enrolled; 81 pt were lost to follow-up. Pt were divided in groups according to the presence of DM and/or CVD as follows: Group A (n = 632), DM (-)/CVD (-); Group B (n = 243), DM (+), CVD (-); Group C (n = 238), DM (-), CVD (+); Group D (n = 322), DM (+), CVD (+). Kaplan-Meier curves for the probability of survival free of events (fatal/non-fatal myocardial infarction, unstable angina, stroke, peripheral artery disease, heart failure) was determined for each group during a mean follow-up of 29 months (range 1 to 138).

results: There were 332 (23.1%) events. Pt in Group A had the lowest incidence of events (14.1%) whereas pt in Group B had the highest (36.0%; P < 0.001). The figure shows that the was no difference in the incidence of events between pt in Groups B (24.3%) and C (28.6%) (P=ns).

conclusions: In pt with CKD stage V, DM is an equivalent to CVD as a long-term predictor of MACE. This data should prompt for an aggressive management of pt with DM and CKD, even without CVD, in order to improve their long-term prognosis.