The association between carotid artery intima-media thickness and cardiovascular mortality and morbidity in Type 2 diabetes: a retrospective study
Hayriye Esra Ataoglu, Mustafa Yenigun, Tayyibe Saler, Zehra Yigit, Levent Temiz, Zuhal Saglam, Faik Çetin, Baki Kumbasar, Fuat Sar & Suleyman Ahbap
Carotid artery intima-media thickness (CCA-IMT) highly correlates with cardiovascular events in type 2 diabetes (T2DM). We aimed to determine the cardiovascular mortality and morbidity incidence regarding CCA-IMT and Framingham Score compared with preceding results of T2DM individuals. Our aim was to determine whether ultrasonographic evaluation of carotid arteries may predict cardiovascular mortality, morbidity and diabetic complications in T2DM patients.
Method: Demographic and clinical data of 102 T2DM individuals were registered including blood pressure, HbA1c, lipid parameters, albumin excretion rate (AER), ECG and ultrasonographic evaluation of carotid IMT and reevaluated seven years later (2004). Primary end point was defined as cardiovascular mortality and morbidity. Student-t test, regression analysis and [chi]2 tests were used. P<0.05 was significant.
Results: The percentage of patients reaching primary end point was 45.10%. Age (P=0.043), diastolic blood pressure (DBP) (P<0.0001), systolic blood pressure (SBP) (P=0.004), A1c% (P=0.042), (AER) (P=0.017), triglyceride levels (P=0.038), IMT/CCA (P=0.001) and percentage of coronary risk assessment by Framingham Score were significantly high(P=0.001) in patients presenting with any of the primary end points. Reevaluation at the end of 7 years revealed that measuring DBP, SBP and IMT/CCA was statistically important at assessing the risk of presenting with any primary end points in T2DM patients (Constant:P<0.0001).
Conclusion: Although Framingham Score predicts 10-year risk for cardiovascular mortality and morbidity in diabetic patients, we suggest that DBP, hypertriglyceridemia and microalbuminuria should also be included in risk scoring as well as the measurement of carotid IMT.