title: Risk of a recurrent cardiovascular event in individuals with type 2 diabetes or intermediate hyperglycemia: the Hoorn Study.
abstract: OBJECTIVE
  To investigate risk of a recurrent cardiovascular event and its predictors in a population-based cohort.
  
  
  METHODS
  Participants of the Hoorn Study who had experienced a first cardiovascular event after baseline (n = 336) were followed with respect to a recurrent event. Absolute risk of a recurrent event was calculated for individuals with normal glucose metabolism, intermediate hyperglycemia, and type 2 diabetes. Cox regression models were used to investigate which variables, measured before the first vascular event, predicted a recurrent event using the stepwise backward procedure.
  
  
  RESULTS
  During a median follow-up of 4.1 years, 44% (n = 148) of the population developed a recurrent vascular event. The rate of recurrent events per 100 person-years was 7.2 (95% CI 5.8-8.7) in individuals with normal glucose metabolism, compared with 9.8 (6.6-14.0) in individuals with intermediate hyperglycemia and 12.5 (8.5-17.6) in individuals with type 2 diabetes. Higher age (hazard ratio 1.02 [95% CI 1.00-1.04]), male sex (1.56 [1.08-2.25]), waist circumference (1.02 [1.02-1.03]), higher systolic blood pressure (1.01 [1.01-1.02]), higher HbA1c (%, 1.13 [0.97-1.31]/ mmol/mol, 1.01 [1.00-1.03]), and family history of myocardial infarction (1.38 [0.96-2.00]) predicted a recurrent cardiovascular event.
  
  
  CONCLUSIONS
  Individuals with type 2 diabetes, but not individuals with intermediate hyperglycemia, are at increased risk for a recurrent vascular event compared with individuals with normal glucose metabolism. In people with a history of cardiovascular disease, people at increased risk of a recurrent event can be identified based on the patient's risk profile before the first event.
authors.affiliation: Corresponding author: Amber A.W.A. van der Heijden, a.vanderheijden@vumc.nl.
authors.forename: Amber A W A
authors.initials: AA
authors.lastname: van der Heijden
authors.forename: Esther
authors.initials: E
authors.lastname: Van't Riet
authors.forename: Sandra D M
authors.initials: SD
authors.lastname: Bot
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Cannegieter
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Baan
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Dekker
authors.forename: Giel
authors.initials: G
authors.lastname: Nijpels
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D016016:Proportional Hazards Models; D012008:Recurrence; D012306:Risk