Associated factors of coronary heart disease in patients with type 2 diabetes mellitus

Abstract

Objective: Type 2 diabetes mellitus (T2DM) has become a major health problem worldwide. World Health Organization estimated that the number of diabetes in Malaysia will increase by 164% in year 2030 compared to year 2000. T2DM leads to a wide range of known complications, including coronary heart disease (CHD), which is among the top three causes of death in Malaysia. The aim of this study was to identify the associated factors of developing CHD in T2DM patients in Malaysia. Design: Retrospective cohort study. Materials and Methods: A retrospective medical record review of 249 T2DM patients attending diabetic clinics in primary health care in a north-eastern state in Malaysia was carried out between June and November 2010. The main outcome variables were newly developed CHD and time from T2DM diagnosis to the diagnosis of CHD. Data were analyzed using Multivariable Cox proportional hazards regression. Results: The mean (SD) age and length of T2DM were 57.0 (8.82) years and 5.76 (4.06) years, respectively. The majority of patients had T2DM for 10 years and less. Only 14.1% of the patients took insulin. The proportion of hypertension and dyslipidemia were 23% and 46%, respectively. The majority were affected by retinopathy (79.1%), followed by nephropathy (31.9%), neuropathy (8.0%) and stroke (4%). Only 12% developed CHD after the median follow up time of six years. The significant factor association with CHD development among T2DM was history of stroke [Adjusted Hazard Ratio: 3.72 (95% confidence interval: 1.41, 9.77), P = 0.008]. © 2013 Japan International Cultural Exchange Foundation & Japan Health Sciences University.