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Vol. 218. Num. 8.November 2018
Pages 391-454
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Vol. 218. Num. 8.November 2018
Pages 391-454
Original article
DOI: 10.1016/j.rceng.2018.04.012
Impact of smoking cessation on estimated cardiovascular risk in Spanish type 2 diabetes mellitus patients: The DIABETES study
Impacto de la cesación tabáquica en el riesgo cardiovascular estimado de pacientes con diabetes mellitus tipo 2: El estudio DIABETES
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M. Luque-Ramíreza, V. Sanz de Burgoab,
Corresponding author
, on behalf of the participants of the DIABETES study
a Grupo de Investigación en Diabetes, Obesidad y Reproducción Humana, Universidad de Alcalá, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
b Departamento Médico, Pfizer S.L.U., Madrid, Spain
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Table 1. Clinical characteristics of the population. Smokers compared with ex-smokers.
Table 2. Comparison of the estimated risk of coronary disease at 10 years (%) according to the cardiovascular risk scales.
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Abstract
Aims

To assess the cardiovascular risk according to the UKPDS risk engine; Framingham function and score comparing clinical characteristics of diabetes mellitus type 2 (DM2) patients according to their habits status.

Patients and methods

A descriptive analysis was performed. A total of 890 Spanish patients with DM2 (444 smokers and 446 former-smokers) were included in a cross-sectional, observational, epidemiological multicenter nationwide study. Coronary heart disease risk at 10 years was calculated using the UKPDS risk score in both patient subgroups. Results were also compared with the Spanish calibrated (REGICOR) and updated Framingham risk scores.

Results

The estimated likelihood of coronary heart disease risk at 10 years according to the UKPDS score was significantly greater in smokers compared with former-smokers. This increased risk was greater in subjects with poorer blood glucose control, and was attenuated in women ≥60 years-old. The Framingham and UKPDS scores conferred a greater estimated risk than the REGICOR equation in Spanish diabetics.

Conclusions

Quitting smoke in patients with DM2 is accompanied by a significant decrease in the estimated risk of coronary events as assessed by UKPDS. Our findings support the importance of quitting smoking among diabetic patients in order to reduce cardiovascular risk.

Keywords:
Type 2 diabetes mellitus
Smoking
Smoking cessation
Cardiovascular risk score
Resumen
Objetivos

Evaluar el riesgo cardiovascular con la herramienta UKPDS risk engine, la función y escala Framingham y comparar las características clínicas de pacientes con diabetes mellitus tipo 2 (DM2) en base a sus hábitos.

Pacientes y métodos

Se llevó a cabo un análisis descriptivo. Se incluyó a un total de 890 pacientes con DM2 (444 fumadores y 446 no fumadores) en un estudio transversal, observacional, epidemiológico, multicéntrico y a nivel nacional. Se calculó el riesgo de enfermedad coronaria a 10 años utilizando, para ello, la puntuación UKPDS en ambas cohortes. Los resultados se compararon también con las puntuaciones calibradas para España (REGICOR) y la escala de riesgo de Framingham.

Resultados

La probabilidad estimada de enfermedad coronaria a los 10 años según la herramienta UKPDS fue ostensiblemente superior en los fumadores que en los no fumadores. Este aumento del riesgo fue mayor en sujetos con un peor control de la glucosa en sangre, y disminuye en mujeres de 60 o más años de edad. Tanto Framingham como UKPDS confieren un riesgo estimado mayor que REGICOR a los diabéticos españoles.

Conclusiones

Dejar de fumar en pacientes con DM2 implica un descenso significativo del riesgo estimado de eventos coronarios según la herramienta UKPDS. Nuestros descubrimientos avalan lo importante que es dejar de fumar en pacientes diabéticos a la hora de reducir el riesgo cardiovascular.

Palabras clave:
Diabetes mellitus tipo 2
Fumar
Cesación tabáquica
Escala de riesgo cardiovascular

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