Abstract P506: Multifactorial Risk Control in Atherosclerotic Cardiovascular Disease Among Patients With Type 2 Diabetes Mellitus: Findings From the UK Biobank

Objectives: To determine the association of simultaneous composite clinical and behavioral risk factor control with incident ASCVD among T2DM patients in the UK. Methods: We studied diagnosed T2DM patients without baseline ASCVD in the UK Biobank database. AHA Life Essential 8 (LE8) metrics included BMI, non-HDL-C, HbA1c, BP, physical activity, nicotine exposure, sleep health, and diet patterns. Each factor was measured at baseline and was assigned a score ranging from 0 to 100 (poor to ideal), with the unweighted average of all factors constituting a composite CV health (CVH) score. Incident ASCVD was defined as the composite outcome of MI, ischemic stroke and CV death. The follow-up period was between baseline enrollment at 2006-2010 and year 2021. Cox proportional hazard models were built to determine the association of each factor, CVH score, as well as the number of ideal control factors, and incident ASCVD adjusted for demographic characteristics. Results: A total of 13,787 T2DM patients were included, 36.4% (5022/13,787) female, 89.1% (12,284/13,787) White, mean age of 60.1 ± 6.8 years, followed up for 11.5 ± 2.9 years. Only 2.2% were at ideal composite control of all factors. ASCVD incidence was significantly lower among those with ideal (>=80) vs. poor (<50) CVH score (adjusted HR=0.30, 95%CI: 0.18-0.51, p<0.0001). Those with ideal simultaneous control for 6 or more LE8 factors had 84% lower ASCVD risks compared to those without any ideal control (adjusted HR=0.16, 95%CI: 0.05-0.51, p<0.01). Conclusion: The composite control of multiple risk factors remains poor among T2DM patients in the UK. Having optimal levels of LE8 metrics simultaneously results in significant ASCVD risk reduction in this population.