The effects of cardiovascular risk factor combined anti-platelet therapy and the risk of cerebrovascular events in patients with T2DM

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 The effects of cardiovascular risk factor 
combined anti-platelet therapy and the risk 
of cerebrovascular events in patients with 
T2DM in an urban community over 
96-months follow-up: The Beijing 
communities diabetes study 19

Abstract

Objective: We investigated the prognostic significance of metabolic risk scores and aspirin with respect to cerebrovascular events.

Methods: A total of 25 communities of diabetic patients were enrolled in Beijing Community Diabetes Study (BCDS) from 2008. 3413 patients with T2DM in BCDS have complete screening data, including blood glucose, blood pressure, lipid profiles and anti-platelet therapy, which were assigned metabolic score (MS) and add up to the total metabolic score (TMS). According to the total metabolic score (TMS), the patients were divided into four equal groups: Group 1 (24 < TMS < 40), Group 2 (40 < TMS < 47), Group 3 (47 < TMS < 55) and Group 4 (55 < TMS < 87). After 96 months, patients were followed-up to assess the long-term effects of the multifactorial interventions.

Results: During 96-months follow-up, a total of 91 cerebrovascular events occurred, including acute cerebral infarction, acute cerebral hemorrhage and transient ischemic attack (TIA). The incidence of cerebrovascular events was higher in the Group 4 than in the Group 1. In Cox multivariate analyses, there are significant differences in incidences of cerebral infarction events among the four groups during the 96-months follow-up. Cox proportional hazards analysis revealed that, HbA1c (p ≤ 0.001), systolic pressure (p ≤ 0.001), aspirin free treatment (P = 0.0023) are independent predictor for cerebrovascular events in diabetic patients.

Conclusions: This study indicates that total metabolic score (TMS) influences the incidence of cerebrovascular events in diabetic patients. In addition to good control of blood glucose, blood pressure and lipid profiles, anti-platelet therapy is important for the prevention of cerebrovascular events in T2DM.

Keywords: Cerebrovascular eventsTotal Metabolic Score (TMS)Anti-platelet therapyType 2 diabetes

Trial registration: ChiCTR-TRC-13003978ChiCTR-OOC-15006090

Ref: Xue-Lian Zhang,Han-Jing Fu, Guang-Ran Yang. Gang Wan, Dongmei Li, Liang-Xiang Zhu,  Beijing Communities Diabetes Study Group, Diabetes Research and Clinical Practice. October 2018Volume 144, Pages 236–244 DOI: https://doi.org/10.1016/j.diabres.2018.09.007

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