467-P: Type 2 Diabetes and Chronic Kidney Disease as Predictors of Cardiovascular Events in Patients with Coronary Artery Disease

This study aims to investigate the single and joint effects of T2DM and CKD on cardiovascular events in patients with coronary artery disease (CAD). We prospectively investigated 1044 patients with CAD over 8.5±5.0 years. Cardiovascular events occurred more frequently in T2DM patients (n=347) than in nondiabetic subjects (60.1% vs 50.6%, p=0.004) and in patients with CKD (eGFR<60ml/min/1.73m2; n=192) than in those without CKD (64.7% vs 51.2%, p<0.001). When both T2DM and CKD were considered, 586 subjects had neither T2DM nor CKD, 266 had T2DM but not CKD, 111 did not have diabetes but had CKD, and 81 had T2DM and CKD. Compared to the incidence of cardiovascular events among patients with neither T2DM nor CKD (49.6%), cardiovascular events were not significantly increased in patients with T2DM who did not have CKD (54.9%; p=0.121) or in nondiabetic patients with CKD (55.9%; p=0.298); however, the incidence of cardiovascular events was significantly increased in patients with the combination of T2DM and CKD (77.2%; p<0.001), in whom it was higher than in those with T2DM but not CKD (p<0.001) or those without T2DM but with CKD (p=0.001). In Cox regression analysis, T2DM (HR 1.31 [1.09-1.57]; p=0.004) and CKD (HR 1.32 [1.05-1.64]; p=0.016) proved to be mutually independent predictors of cardiovascular events after multivariate adjustment for age, sex, BMI, history of smoking, hypertension, LDL-C and HDL-C. We conclude that T2DM and CKD in patients with CAD are mutually independent predictors of cardiovascular events. CAD patients with both CKD and T2DM are at an extremely high risk for cardiovascular events.