418-P: Chronic Kidney Disease Is a Type 2 Diabetes Risk Equivalent in Patients with Established Coronary Artery Disease

Both type 2 diabetes (T2DM) and chronic kidney disease (CKD) confer a high risk of cardiovascular disease (CVD). We aimed at investigating the single and joint effects of T2DM and of CKD on cardiovascular event risk in high-risk patients with established coronary artery disease (CAD). We prospectively investigated 1460 patients with angiographically proven CAD over 10.3±4.8 years. Cardiovascular events occurred more frequently in T2DM patients (n=449) than in nondiabetic subjects (56.2% vs. 44.5%; p<0.001) and in patients with CKD (eGFR <60ml/min/1.73m²; n=264) than in those with an eGFR ≥60ml/min/1.73m² (61.7% vs. 45.1%; p<0.001). When both, T2DM and CKD were considered, 856 subjects had neither T2DM nor CKD, 340 had T2DM but not CKD, 155 did not have diabetes but had CKD, and 109 had both T2DM and CKD. When compared with the cardiovascular event rate among patients with neither T2DM nor CKD (42.5%), cardiovascular risk was significantly higher in patients with T2DM who did not have CKD (51.5%; p=0.002) as well as in nondiabetic patients with CKD (55.2%; p=0.009) and was highest in patients with both, T2DM and CKD (71.0%; p<0.001), in whom the event risk was higher than in those with T2DM but no CKD (p<0.001) or those without T2DM but with CKD (p=0.005); event risk however was did not differ significantly between nondiabetic CKD patients and T2DM patients who did not have CKD (p=0.692). We conclude that CKD is a T2DM risk equivalent in patients with established CAD.