Predictors of all-cause mortality and major adverse cardiovascular events (MACEs) in subjects with diabetes
| All-cause mortality | MACE | ||||||||
| DM cohort | No. at risk | No. of events (%) | Adjusted HR* | 95% CI | P value | No. of events (%) | Adjusted HR* | 95% CI | P value |
| Glycemic control† | |||||||||
| HbA1c (%) | 1806 | 231 (12.8) | 1.05 | 0.99 to 1.12 | 0.115 | 259 (14.3) | 1.18 | 1.11 to 1.26 | <0.001 |
| HbA1c <6.5 | 316 | 38 (12.0) | Ref | 34 (10.8) | Ref | ||||
| 6.5≥HbA1 c<8 | 781 | 82 (10.5) | 0.86 | 0.58 to 1.26 | 0.430 | 88 (11.3) | 1.07 | 0.72 to 1.61 | 0.737 |
| HbA1c ≥8 | 709 | 111 (15.6) | 1.12 | 0.77 to 1.62 | 0.548 | 137 (19.3) | 1.87 | 1.26 to 2.78 | 0.002 |
| HbA1c <7 | 652 | 73 (11.2) | Ref | 67 (10.3) | Ref | ||||
| 7≥HbA1c<8 | 445 | 47 (10.6) | 0.89 | 0.62 to 1.29 | 0.550 | 55 (12.4) | 1.28 | 0.89 to 1.85 | 0.186 |
| HbA1c ≥8 | 709 | 111 (15.6) | 1.19 | 0.89 to 1.61 | 0.246 | 137 (19.3) | 2.11 | 1.54 to 2.90 | <0.001 |
| Microvascular complications | |||||||||
| Diabetic retinopathy | |||||||||
| No | 1213 | 126 (10.4) | Ref | 152 (12.5) | Ref | ||||
| Yes | 622 | 108 (17.3) | 1.31 | 0.97 to 1.78 | 0.074 | 111 (17.8) | 1.16 | 0.88 to 1.53 | 0.278 |
| eGFR (mL/min/1.73 m2) | 1810 | 233 (12.9) | 0.973 | 0.967 to 0.980 | <0.001 | 262 (14.5) | 0.983 | 0.977 to 0.990 | <0.001 |
| CKD (eGFR <60 mL/min/1.73m2) | |||||||||
| No | 1463 | 119 (8.1) | Ref | 154 (10.5) | Ref | ||||
| Yes | 347 | 114 (32.8) | 2.34 | 1.74 to 3.14 | <0.001 | 108 (31.0) | 1.88 | 1.42 to 2.49 | <0.001 |
| Overall microvascular complications | |||||||||
| None | 987 | 62 (6.3) | Ref | 94 (9.5) | Ref | ||||
| DR or CKD | 677 | 128 (18.9) | 2.13 | 1.54 to 2.94 | <0.001 | 123 (18.2) | 1.40 | 1.05 to 1.86 | 0.021 |
| DR and CKD | 146 | 47 (32.2) | 3.24 | 2.14 to 4.92 | <0.001 | 48 (32.9) | 2.28 | 1.55 to 3.34 | <0.001 |
| Glycemic control and microvascular complications | |||||||||
| None, HbA1c <8 | 644 | 36 (5.6) | Ref | 42 (6.5) | Ref | ||||
| DR or CKD, HbA1c <8 | 358 | 63 (17.6) | 2.08 | 1.34 to 3.21 | 0.001 | 55 (15.4) | 1.62 | 1.07 to 2.47 | 0.022 |
| DR and CKD, HbA1c <8 | 75 | 20 (26.7) | 2.60 | 1.45 to 4.67 | 0.001 | 25 (33.3) | 3.35 | 2.00 to 5.63 | <0.001 |
| None, HbA1c ≥8 | 338 | 25 (7.4) | 1.18 | 0.70 to 2.01 | 0.529 | 52 (15.4) | 2.40 | 1.58 to 3.66 | <0.001 |
| DR or CKD, HbA1c ≥8 | 284 | 56 (19.7) | 2.61 | 1.67 to 4.10 | <0.001 | 59 (20.8) | 2.67 | 1.76 to 4.07 | <0.001 |
| DR and CKD, HbA1c ≥8 | 70 | 26 (37.1) | 4.46 | 2.55 to 7.78 | <0.001 | 23 (32.9) | 3.40 | 1.95 to 5.92 | <0.001‡ |
| ‡Pinteraction | 0.725 | ‡Pinteraction | 0.031 | ||||||
*Adjusted for age, gender, race, BMI, current smoking status, systolic blood pressure, cholesterol and duration of diabetes.
†For impact of HbA1c on all-cause mortality, crude rates are reported. Multivariable analysis are not performed as univariable analysis are not significant.
‡Pinteraction for diabetic complications (none, DR or CKD, DR and CKD) × glycemic control (Hba1c <8, Hba1c ≥8).
BMI, body mass index; CKD, chronic kidney disease; DR, diabetic retinopathy.