Premature Mortality in Type 2 Diabetes Mellitus Associated with Heart Failure and Chronic Kidney Disease: 20 Years of Real-World Data.

Autor: Gavina C; Cardiology Department, Pedro Hispano Hospital, 4464-513 Matosinhos, Portugal., Carvalho DS; Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, 4050-313 Porto, Portugal., Dias DM; Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, 4050-313 Porto, Portugal.; Family Health Unit Ao Encontro da Saúde, ACeS Grande Porto I-Santo Tirso/Trofa, 4745-559 Trofa, Portugal ., Bernardo F; Medical Department, AstraZeneca, 2730-097 Barbarena, Portugal., Martinho H; Medical Department, AstraZeneca, 2730-097 Barbarena, Portugal., Couceiro J; Medical Department, AstraZeneca, 2730-097 Barbarena, Portugal., Santos-Araújo C; Nephrology Department, Pedro Hispano Hospital, 4464-513 Matosinhos, Portugal.; UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal., Dinis-Oliveira RJ; TOXRUN-Toxicology Research Unit, University Institute of Health Sciences, Advanced Polytechnic and University Cooperative (CESPU), CRL, 4585-116 Gandra, Portugal.; Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.; UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal., Taveira-Gomes T; Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, 4050-313 Porto, Portugal.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2022 Apr 11; Vol. 11 (8). Date of Electronic Publication: 2022 Apr 11.
DOI: 10.3390/jcm11082131
Abstrakt: Introduction: Type 2 diabetes mellitus (T2D) increases the risk of heart failure (HF) and chronic kidney disease (CKD). Nonetheless, evidence of cardiovascular (CV) prognosis is relatively scarce in young T2D patients.
Purpose: To estimate the risk of all-cause death, CV death, and non-fatal major CV events (MACEs) in T2D patients younger than 65 years old.
Methods: We designed a retrospective cohort study using incident cases of either T2D, HF, or CKD in the population aged 40-65 years, from 1st January 2000 to 31st December 2019. Each individual was followed for up to one year. The primary analysis consisted of survival analysis with Cox proportional hazards to compare one-year risk of all-cause death, CV death, and MACEs between T2D without HF or CKD (T2D), T2D with HF (T2D-HF), and T2D with CKD (T2D-CKD) groups.
Results: A total of 14,986 incident adult diabetic patients from the last two decades in our institution were included with an average age at cohort inclusion of 55-58 years old. Glycemic control was similar among groups. The adjusted hazard ratio (HR) of one-year all-cause death was 2.77 (95% CI: 2.26-3.40) for T2D-HF and 3.09 (2.77-3.45) for T2D-CKD compared with the baseline T2D risk. The highest event rate (T2D-CKD) was 0.15 per person-year. The adjusted HR of one-year CV death was 2.75 (95% CI: 2.19-3.46) for T2D-CKD and 2.59 (1.72-3.91) for T2D-HF. The non-fatal MACE risk was significantly increased in T2D-HF or T2D-CKD compared with T2D (2.82 (CI95%: 2.34-3.41) for T2D-CKD vs. 1.90 (CI95%: 1.66-2.17) for T2D-CKD) with a 32% event rate in non-fatal MACEs.
Conclusions: Coexistence of HF or CKD is associated with increased premature mortality as well as non-fatal CV events in T2D patients under 65 years old.
Databáze: MEDLINE
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