title: Relevance of target-organ lesions as predictors of mortality in patients with diabetes mellitus.
abstract: BACKGROUND
  Patients with diabetes are in extract higher risk for fatal cardiovascular events.
  
  
  OBJECTIVE
  To evaluate major predictors of mortality in subjects with type 2 diabetes.
  
  
  METHODS
  A cohort of 323 individuals with type 2 diabetes from several regions of Brazil was followed for a long period. Baseline electrocardiograms, clinical and laboratory data obtained were used to determine hazard ratios (HR) and confidence interval (CI) related to cardiovascular and total mortality.
  
  
  RESULTS
  After 9.2 years of follow-up (median), 33 subjects died (17 from cardiovascular causes). Cardiovascular mortality was associated with male gender; smoking; prior myocardial infarction; long QTc interval; left ventricular hypertrophy; and eGFR <60 mL/min. These factors, in addition to obesity, were predictors of total mortality. Cardiovascular mortality was adjusted for age and gender, but remained associated with: smoking (HR = 3.8; 95% CI 1.3-11.8; p = 0.019); prior myocardial infarction (HR = 8.5; 95% CI 1.8-39.9; p = 0.007); eGFR < 60 mL/min (HR = 9.5; 95% CI 2.7-33.7; p = 0.001); long QTc interval (HR = 5.1; 95% CI 1.7-15.2; p = 0.004); and left ventricular hypertrophy (HR = 3.5; 95% CI 1.3-9.7; p = 0.002). Total mortality was associated with obesity (HR = 2.3; 95% CI 1.1-5.1; p = 0.030); smoking (HR = 2.5; 95% CI 1.0-6.1; p = 0.046); prior myocardial infarction (HR = 3.1; 95% CI 1.4-6.1; p = 0.005), and long QTc interval (HR = 3.1; 95% CI 1.4-6.1; p = 0.017).
  
  
  CONCLUSIONS
  Biomarkers of simple measurement, particularly those related to target-organ lesions, were predictors of mortality in subjects with type 2 diabetes.
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Henrique Tria
authors.initials: HT
authors.lastname: Bianco
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Izar
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Henrique Andrade
authors.initials: HA
authors.lastname: Fonseca
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Rui Manuel
authors.initials: RM
authors.lastname: Póvoa
authors.affiliation: Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil.
authors.forename: José Francisco
authors.initials: JF
authors.lastname: Saraiva
authors.affiliation: Centro de Diabetes e Hipertensão de Fortaleza, Fortaleza, CE, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Forti
authors.affiliation: Universidade Federal de Goiânia, Goiânia, GO, Brazil.
authors.forename: Paulo Cesar B V
authors.initials: PC
authors.lastname: Jardim
authors.affiliation: Centro de Investigação Clínica de Brasília, Brasília, DF, Brazil.
authors.forename: Luis
authors.initials: L
authors.lastname: Introcaso
authors.affiliation: Escola de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
authors.forename: Juan
authors.initials: J
authors.lastname: Yugar-Toledo
authors.affiliation: Centro de Investigação Clínica de Santos, Santos, SP, Brazil.
authors.forename: Hermes Tóros
authors.initials: HT
authors.lastname: Xavier
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
authors.forename: André Arpad
authors.initials: AA
authors.lastname: Faludi
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Francisco A H
authors.initials: FA
authors.lastname: Fonseca
mesh_terms: D000368:Aged; D001938:Brazil; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000401:mortality*; D004562:Electrocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D051437:Renal Insufficiency / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D018709:Statistics, Nonparametric
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