J Natl Med Assoc. 2026 Feb 14:S0027-9684(26)00029-5. doi: 10.1016/j.jnma.2026.02.005. Online ahead of print.
ABSTRACT
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality among patients with type 2 diabetes mellitus (T2DM). Advanced age and poor glycemic control are recognized risk factors, yet data from low-resource settings remain limited. This study aimed to identify predictors of Composite cardiovascular events among adults with T2DM in central Ethiopia.
METHODS: We conducted a five-year retrospective cohort study from January 1, 2020, to December 31, 2025, including 7280 adult T2DM patients receiving follow-up at selected hospitals in central Ethiopia. Patients with type 1 diabetes, gestational diabetes, end-stage organ failure, or incomplete records were excluded. Data on sociodemographics, clinical characteristics, laboratory values, medication use, and cardiovascular outcomes were extracted from medical records. Composite cardiovascular events included myocardial infarction, stroke, unstable angina, or heart failure. Cox proportional hazards regression was used to identify independent predictors of cardiovascular events.
RESULTS: The mean age of participants was 48.7 ± 12.6 years, and 59 % were male. Thirty years with in the study period of 5 years was a maximum follow up time, a median follow up time were 14 year and 7 month, and a minimum follow up time were 2nd visit after (three month) the diagnosis of type two DM. Over the study period, 2475 patients (34.1 %) developed cardiovascular events, corresponding to an incidence rate of 339.9 per 1000 person-years. Median time to event was 18.3 years. Multivariable Cox regression analysis showed that advanced age significantly increased the hazard of cardiovascular events (AHR 4.5; 95 % CI: 2.06-6.7). Elevated HGB-A1C (≥7 %) was associated with a threefold higher risk (AHR 3.02; 95 % CI: 2.25-5.09), and triglyceride ≥150 mg/dL also predicted increased risk (AHR 3.72; 95 % CI: 2.2-5.42).
CONCLUSION: Advanced age, poor glycemic control, and hypertriglyceridemia were independent predictors of Composite cardiovascular events among adults with T2DM in central Ethiopia. These findings underscore the need for early risk stratification, aggressive management of hyperglycemia and dyslipidemia, and targeted interventions for older patients to reduce the cardiovascular burden in resource-limited settings.
PMID:41791937 | DOI:10.1016/j.jnma.2026.02.005