Although both a glucose metabolism abnormality and prior cerebrovascular disease (CVD) are major predictors of CVD, few studies have compared their impact on a subsequent CVD event. Also, few studies evaluated risk of prediabetes separately from nondiabetic categories. Thus, the impact of diabetes mellitus (DM) on subsequent CVD compared to normal glucose tolerance (NGT) could have been underestimated. We analyzed a nationwide claims-based database of 290,865 participants in 2008-14. Participants were classified as having NGT, prediabetes or DM based on fasting plasma glucose, HbA1c and use of antihypoglycemic agents (185,648 with NGT; 87,867 with prediabetes; 17,350 with DM). Participants were also classified as with or without prior CVD based on ICD-10 and questionnaires (1,944 with prior CVD; 288,921 without prior CVD). Cox regression model showed that prediabetes and DM confers about 1.1- and 1.4-fold excess risk for CVD, respectively, compared to NGT without prior CVD. Prediabetes and DM does not increase risk for CVD compared to NGT with prior CVD (Table). Prior CVD confers a 4-7-fold excess risk for CVD regardless of glucose tolerance status. Hazard ratio of CVD in NGT with prior CVD was 4 times higher than in DM without prior CVD. This implies that prediabetes and DM increase CVD only in those without prior CVD. Prior CVD confers a higher risk for subsequent CVD regardless of glucose tolerance status.
D. Yanagisawa: None. K. Fujihara: None. T. Osawa: None. M. Kitazawa: None. M. Yamamoto: None. Y. Matsubayashi: None. N. Yamanaka: None. S. Kodama: None. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.