Cardiovascular risk factors as predictors of mortality in type II diabeticpatients

Background. Mortality among diabetic patients is high and attempts have bee n made to find clinical markers which would help to identify patients at ri sk. Main purpose. The purpose of this study was to assess whether cardiovascula r risk factors like previous myocardial infarction, left ventricular dysfun ction, hypertension, renal insufficiency, and 24-hour mean or minimum heart rate, significantly contribute to the mortality in this group of patients. Methods. 45 male patients with type II diabetes mellitus were studied by am bulatory electrocardiography to obtain the information about the 24-hour me an and minimum heart rates; records from baseline hospitalization were revi ewed for clinical variables. After 55 months mortality data were retrieved. Cox's proportional hazards regression model was used to study the effect o f clinical variables on mortality in multivariate analysis. Results. All-cause mortality was 38%. The groups of survivors and nonsurviv ors differed significantly in terms of age, the presence of left ventricula r dysfunction and renal insufficiency. No significant difference in 24-hour mean or minimum heart rate was registered. In the Cox's model, the presenc e of left ventricular dysfunction, renal insufficiency and age significantl y and independently predicted mortality. Conclusions. The present study, showed that left ventricular dysfunction an d renal insufficiency were related to the all-cause mortality of type II di abetic patients independently of age, after 55 months of follow-up. Prognos tic significance of 24-hour mean or minimum heart rate has not been proven.