Photo Credit: Foremniakowski

The following is a summary of “Contribution of type 2 diabetes to major adverse cardiovascular events (MACE) in a long-term observational study with different stages of atherosclerosis,” published in the January 2025 issue of Endocrinology by Mader et al. 

Researchers conducted a retrospective study to investigate major adverse cardiovascular events (MACE) in patients with or without type 2 diabetes (T2DM) presenting with minor coronary atherosclerotic lesions or symptomatic peripheral artery disease.  

They included 1,238 patients from 2 long-term cohort studies. Patients underwent coronary angiography and/or sonography to assess atherosclerosis grade, categorized as no atherosclerosis (n = 332; Group I), minor atherosclerosis (n = 425; Group II), and major atherosclerosis (n = 481; Group III). Cardiovascular events were recorded over a median follow-up of 7.1 years (Q1 = 3.6 years, Q2 = 7.1 years, Q3 = 11.3 years), totalling 9,533 patient-years. The study tested whether T2DM confers a consistent relative risk increase across all stages of atherosclerosis, using 3-point MACE as the primary endpoint.  

The results showed that incident MACE occurred in 681 patients (51%) and the MACE was more frequent in patients with T2DM than those without T2DM (P < 0.001), MACE rates were higher in group III (58.1%) compared to group II (34.1%) and group I (19.1%) (group I vs group II vs group III, P < 0.001). In Cox regression, T2DM was a predictor of MACE in univariate analyses (HR = 2.43 [1.88–3.14], P < 0.001) and after multivariate adjustment for cardiovascular risk factors and atherosclerosis grades (HR = 1.37 [1.02–1.84], P = 0.034). Atherosclerosis grades also predicted MACE in univariate (HR = 3.19 [2.75–3.70], P < 0.001) and multivariate analyses (HR = 1.61 [1.31–1.98], P < 0.001), adjusting for cardiovascular risk factors, including T2DM.  

Investigators concluded that T2DM independently increases the risk for MACE across all stages of atherosclerosis, regardless of the specific anatomical or morphological characteristics of the atherosclerotic lesions.  

Source: nature.com/articles/s41598-024-84985-x