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Overall, 1,069 patients developed CHF, 970 cases stroke, 693 cases angina pectoris, 578 cases had TIA, and 508 patients developed MI. Five percent (5.4%) of all patients with a DSC during follow-up had a CHF diagnosis compared with 3.8% of all patients without DSC during follow-up. An incident Pomalidomide supplier angina pectoris diagnosis was recorded for 1% of patients with DSC and for 2.6% without DSC, an incident MI occurred in 1.7% of patients with DSC and in 1.8% of patients with DSC, an incident stroke diagnosis was diagnosed in 3.2% of patients with DSC and in 3.5% without DSC, and 1.2% had a TIA diagnosis among those with DSC and 2.1% among those without DSC. In the time-varying Cox regression analysis adjusted for age, body mass index, sex, and smoking status and use of ACE-inhibitors, angiotensin II receptor blockers, calcium channel blocker, beta-blockers, diuretics, or aldosterone antagonists at baseline, the risks of developing angina pectoris or TIA were similar for patients with DSC compared with patients without DSC, yielding HRs of 1.18 (95% confidence interval [CI] 0.66�C2.10) and of 1.32 (95% CI 0.78�C2.22), respectively. The adjusted HRs for CHF, MI, and stroke were 2.98 (95% Nutlin-3a purchase CI 2.27�C3.89), 2.53 (95% CI 1.62�C3.96), and 1.93 (95% CI 1.38�C2.69), respectively, for patients with or without DSC. When we stratified by sex, the relative risk (RR) of TIA was similar for males and females, while for all other outcomes the risk estimates differed to some degree. The most pronounced difference was observed for MI, with an HR of 3.32 (95% CI 1.85�C5.93) for females compared with 1.84 (95% CI 0.90�C3.76) in males (Table 2). Table 2 Risk of cardiovascular outcomes in patients with DSC Oxymatrine compared with patients without DSC The sensitivity analyses for MI and stroke in which we restricted the analyses to cases with additional evidence supporting the diagnosis included 459 patients with MI and 763 patients with a stroke diagnosis. In this subgroup, the HR for MI was 2.68 (95% CI 1.67�C4.29), again with a substantial difference between males (HR 1.94, 95% CI 0.90�C4.18) and females (HR 3.46, 95% CI 1.89�C6.33). The overall HR of stroke in this sensitivity analysis was 2.14 (95% CI 1.50�C3.06). The HRs for males and females were 1.79 (95% CI 1.02�C3.15) and 2.41 (95% CI 1.52�C3.84), respectively. In a second sensitivity analysis, we restricted the study population to patients whose first eGFR was lower than 60 mL/min per 1.73 m2. As there were only 3,718 such patients in total, most risk estimates did not reach statistical significance. The results are displayed in Table 3. Table 3 DSC status and risk of cardiovascular outcomes in patients with eGFR