Hematocrit, independent of chronic kidney disease, predicts adverse cardiovascular outcomes in Chinese patients with type 2 diabetes

OBJECTIVE - Anemia and chronic kidney disease (CKD) are risk factors for cardiovascular diseases in diabetes. We examined the association between hematocrit, stratified by the presence of CKD, and cardiovascular events in a cohort of Chinese subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS - A total of 3,983 patients who underwent assessment for diabetes complications were recruited, Subjects were categorized into five groups. range. The Group I included subjects with hematocrit below the normal sex-specific sex. or each hematocrit points for groups II-V were selected to represent the distribution CKD was defined by the estimated glomerular filtration rate < 60 ml/min per 1.73 m(2). Cardiovascular events were defined as cardiovascular mortality and morbidity, including new onset of myocardial infarction, acute coronary syndrome, revascularization, heart failure, and stroke requiring hospitalization. RESULTS - A total of 294 subjects (7.4%) developed cardiovascular events during the median of 36.4 months. The rate of cardiovascular events was highest in subjects with low hematocrit (group 1, 18.6%) compared with group V (3.4%, P < 0.001). The multivariate-adjusted hazard ratio for cardiovascular events diminished with increasing hematocrit (group 1, 1.0; group 11, 0.73 [95% CI 0.51-1.04]; group 111, 0.57 [0.39-0.83]; group IV, 0.61 [0.39-0.95]; the previously presence of CKD by the After stratifin 791) 17 0 0 36 [0 V p y. . group, an observed reduction in the risk of developing cardiovascular events with increasing hematocrit was abolished in the cohort with CKD but persisted in the non-CKD cohort. CONCLUSIONS - in Chinese subjects with type 2 diabetes, low levels of hematocrit and the presence of CKD are associated with increased risk of developing adverse cardiovascular events.