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Type 2 diabetes (T2D) and prediabetes are well known to be associated with an increased risk of coronary artery disease (CAD). However, it remains unclear whether the magnitude of effect of traditional risk factors for cardiovascular disease on the incidence of CAD in those with T2D and prediabetes differ from those in normoglycemic individuals. Thus, we compare the influence of traditional risk factors (age, sex, BMI, SBP, HDLC, LDLC, HbA1c, estimated GFR, smoking, physical activity habit, antihypertensive drugs, hypolipidemic drug) on the incidence of CAD according to glucose tolerance status. Using a nationwide claim-based database that included 512,901 people aged 18-75 y in Japan (512,901 with normal glucose tolerance; 225,403 with prediabetes; 43,624 with T2D). The areas under the receiver operation characteristic (ROC) curves (AUCs) were calculated for the detection of CAD. During a median follow-up period of 5.0 years, 3,836 cases of CAD occurred. ROC analysis showed that compared to those with normal glucose tolerance, the AUCs decreased in association with worsening of glucose tolerance (Fig). The AUCs in the ROC curve analyses of normal glucose tolerance status, prediabetes and T2D were 0.843 (0.833-0.853), 0.795 (0.785-0.806), and 0.713 (0.698-0.729), respectively). Results suggest that it is inadequate to predict CAD in people with T2D based on traditional risk factors alone. Disclosure K. Fujihara: None. Y. Matsubayashi: None. M.H. Yamada: None. M. Yamamoto: None. T. Osawa: None. M. Kitazawa: None. T. Sato: None. H. Suzuki: None. H. Ishiguro: None. T. Yamada: None. Y. Yaguchi: None. S. Kodama: None. H. Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Eisai Inc., Sumitomo Dainippon Pharma Co., Ltd.
Fujihara et al. (Fri,) studied this question.