Risk stratification for cardiovascular disease based on prior coronary artery disease, cerebrovascular disease and type 2 diabetes mellitus.

Autor: Oe M; Faculty of Medicine, Niigata University, Niigata, Japan.; Kowa Company, Ltd., Tokyo, Japan., Fujihara K; Faculty of Medicine, Niigata University, Niigata, Japan., Yamada MH; Faculty of Medicine, Niigata University, Niigata, Japan., Osawa T; Faculty of Medicine, Niigata University, Niigata, Japan., Kitazawa M; Faculty of Medicine, Niigata University, Niigata, Japan., Matsubayashi Y; Faculty of Medicine, Niigata University, Niigata, Japan., Sato T; Faculty of Medicine, Niigata University, Niigata, Japan., Yaguchi Y; Faculty of Medicine, Niigata University, Niigata, Japan., Iwanaga M; Faculty of Medicine, Niigata University, Niigata, Japan., Yamada T; Faculty of Medicine, Niigata University, Niigata, Japan., Sone H; Faculty of Medicine, Niigata University, Niigata, Japan.
Jazyk: angličtina
Zdroj: Journal of diabetes investigation [J Diabetes Investig] 2024 Oct; Vol. 15 (10), pp. 1464-1471. Date of Electronic Publication: 2024 Aug 01.
DOI: 10.1111/jdi.14277
Abstrakt: Aims/introduction: History of coronary artery disease (CAD), cerebrovascular disease (CeVD), type 2 diabetes and their combined effect on cardiovascular disease are essential for cardiovascular risk management. We investigated the association of prior CAD, prior CeVD, type 2 diabetes and their combination with the risk of cardiovascular disease.
Materials and Methods: This is a historical cohort study including 342,033 participants (aged 18-72 years) followed up for ≥5 years between 2008 and 2016. Participants were classified into eight groups (with or without prior CAD, prior CeVD and type 2 diabetes). Type 2 Diabetes was defined by fasting plasma glucose and glycated hemoglobin levels, and antidiabetic drug prescription. Prior and subsequent CAD and CeVD were identified according to claims using International Classification of Diseases 10th Revision codes, medical procedures and questionnaires. Cox regression models were used to evaluate the risk of cardiovascular events.
Results: The median follow-up period was 6.4 years. The incidence of composite cardiovascular events of CAD and CeVD in the CAD-/CeVD-, CAD+/CeVD-, CAD-/CeVD+ and CAD+/CeVD+ groups were 1.92 and 6.94, 25.14 and 31.98 per 1,000 person-years in non-diabetes participants, and 8.66, 18.04, 39.98 and 60.72 in type 2 diabetes patients, respectively. Hazard ratios of cardiovascular events compared with CAD-/CeVD-/non-diabetes were 1.66 (95% confidence interval 1.55-1.78) in CAD-/CeVD-/type 2 diabetes and 1.84 (1.56-2.18) in CAD+/CeVD-/non-diabetes. CeVD+ was linked to a 4-7-fold increase in the risk of cardiovascular events regardless of CAD+ or type 2 diabetes.
Conclusions: Type 2 diabetes increased the risk of cardiovascular disease as high as a history of CAD, whereas prior CeVD alone increased the risk of future CeVD without additional effects by type 2 diabetes.
(© 2024 The Author(s). Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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