Table 2.
Multivariable analysis of factors associated with incident first acute myocardial infarction in the MADIABETES cohort.
| Initial model | Final modela | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Risk factors | Hazard ratio | 95% confidence interval | p value | Risk factorsb | Hazard ratio | 95% confidence interval | p value | ||
| Female sex | 0.72 | 0.48 | 1.08 | 0.112 | Female sex | 0.74 | 0.50 | 1.09 | 0.122 |
| Age (per each 1-year increment) | 1.02 | 1.01 | 1.04 | 0.044 | Age ≥ 75 years old (reference < 75 years) | 1.62 | 1.08 | 2.42 | 0.019 |
| HbA1c (per each 11-mmol/mol increment) | 1.09 | 0.96 | 1.25 | 0.075 | HbA1c (reference < 53 mmol/mol) | 0.002 | |||
| 53–64 mmol/mol | 0.80 | 0.48 | 1.32 | 0.382 | |||||
| > 64 mmol/mol | 1.95 | 1.24 | 3.04 | 0.003 | |||||
| HDL-cholesterol (per each 0.03-mmol/L increment) | 0.98 | 0.97 | 1.02 | 0.072 | HDL-cholesterol (reference < 0.90 mmol/L) | 0.010 | |||
| 0.90–1.81 mmol/L | 0.50 | 0.32 | 0.78 | 0.002 | |||||
| > 1.81 mmol/L | 0.58 | 0.25 | 1.34 | 0.203 | |||||
| DBP (per each 1-mmHg increment) | 0.97 | 0.95 | 0.99 | 0.045 | DBP (reference < 65 mmHg) | 0.000 | |||
| 65–85 mmHg | 0.41 | 0.26 | 0.63 | 0.000 | |||||
| > 85 mmHg | 0.60 | 0.30 | 1.21 | 0.155 | |||||
| Albuminuria (per each 1-mg/dL increment) | 1.01 | 0.98 | 1.04 | 0.082 | Albuminuria (reference < 30 mg/dL) | 0.114 | |||
| 30–300 mg/dL | 1.18 | 0.67 | 2.07 | 0.560 | |||||
| > 300 mg/dL | 2.61 | 1.04 | 6.52 | 0.040 | |||||
| BMI (per each 1-kg/m2 increment) | 1.01 | 0.97 | 1.05 | 0.772 | |||||
| Diabetes duration (per each 1-year increment) | 1.00 | 0.98 | 1.02 | 0.936 | |||||
| Current smoker (yes vs. no) | 1.11 | 0.64 | 1.90 | 0.718 | |||||
| Statins (yes vs. no) | 0.95 | 0.64 | 1.42 | 0.797 | |||||
| Diabetes treatment (reference lifestyle changes) | 0.970 | ||||||||
| Oral antihyperglycemic drugs | 1.03 | 0.62 | 1.71 | 0.903 | |||||
| Insulin ± other antihyperglycemic drugs | 1.08 | 0.56 | 2.08 | 0.809 | |||||
| Aspirin (yes vs. no) | 1.08 | 0.73 | 1.60 | 0.689 | |||||
| LDL-cholesterol (per each 0.03-mmol/L increment) | 1.01 | 1.00 | 1.02 | 0.263 | |||||
| Total cholesterol (per each 0.03-mmol/L increment) | 1.00 | 0.99 | 1.01 | 0.487 | |||||
| SBP (per each 1-mmHg increment) | 1.01 | 0.99 | 1.02 | 0.315 | |||||
| GFR (per each 1-mL/min/1.73 m2 increment) | 1.00 | 0.99 | 1.01 | 0.496 | |||||
| Retinopathy (yes vs. no) | 1.27 | 0.74 | 2.17 | 0.384 | |||||
| Neuropathy (yes vs. no) | 1.25 | 0.66 | 2.35 | 0.497 | |||||
| Triglycerides (per each 0.01-mmol/L increment) | 1.00 | 0.99 | 1.00 | 0.225 | |||||
| Antihypertensive treatment (yes vs. no) | 1.92 | 1.07 | 3.44 | 0.028 | Stratified variablec | ||||
BMI Body mass index, HbA1c Glycated hemoglobin, HDL-cholesterol High-density lipoprotein cholesterol, DBP Diastolic blood pressure, LDL-cholesterol Low-density lipoprotein cholesterol, SBP Systolic blood pressure, GFR Glomerular filtration rate.
aBackward elimination (Supplementary Fig. S1).
bHDL-cholesterol, Albuminuria, DBP, and HbA1c were kept as continuous variables for descriptive analyses and the initial Cox regression model. Subsequently, the variables were categorized, given their non-linear effect on outcomes (Supplementary Figs. S2 and S3). Age was categorized according to clinical relevance.
cThe inclusion as an independent variable produced inconsistent results given that the vast majority of the cardiovascular events were concentrated in the category of patients taking antihypertensive drugs. We repeated the analysis by stratifying by this variable that allows taking it into account in the adjustment and solving this problem.