82-OR: Association of Diabetic Complications and Various Comorbidities with Major Adverse Cardiovascular Events in Type 2 Diabetes and Their Development over Time—A Danish Registry-Based Case-Control Study

Introduction and Objective: Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular disease (CVD). This study aimed to investigate the association between risk factors for major adverse cardiovascular events (MACE) over time.

Methods: In this case-control study, data from Danish registries was utilized to identify peopled diagnosed with T2DM between 1999-2018 (n=347,121) and then subdivided into cases and controls for each of two 10-year time periods; TP1: 1999-2008 and TP2: 2009-2018. Cases were defined as having suffered three-point MACE (n_TP1=13,584, n_TP2=10,823) with controls matched 1:1 on age, gender, and T2DM duration. Exposures were preselected diabetic complications and comorbidities, identified using ICD-10 and/or ATC codes. The association was analyzed using conditional logistic regression.

Results: Comorbidities strongly associated with MACE included hypertension (OR_TP1 = 2.32, 95% CI 2.18-2.47 OR_TP2 = 1.92, 95% CI 1.81-2.04), hypercholesterolemia (OR_TP1 = 1.73, 95% CI 1.60-1.86, OR_TP2 = 1.25, 95% CI 1.17-1.32), diabetic complications; nephropathy (OR_TP1 = 1.77, 95% CI 1.48-2.11, OR_TP2 = 1.74, 95% CI 1.41-2.15), neuropathy (OR_TP1 = 2.27, 95% CI 2.06-2.49 OR_TP2 = 1.95, 95% CI 1.78-2.13) and retinopathy (OR_TP1 = 1.18, 95% CI 1.05-1.34, OR_TP2 = 1.51, 95% CI 1.28-1.78). Hypercholesterolemia and hypertension showed a significant decrease between the periods. Additionally, osteoarthritis (OR_TP1 = 0.83, 95% CI 0.75-0.92 OR_TP2 = 0.81, 95% CI 0.74-0.88) exhibited a significant inverse association with MACE.

Conclusion: These results suggested that certain risk factors improved over time. However, there is still a need for further improvement in the prevention of MACE in T2DM.