Major adverse cardiovascular events' reduction and their association with glucose-lowering medications and glycemic control among patients with type 2 diabetes: A retrospective cohort study using electronic health records.

Autor: Hsu H; Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.; Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, Pennsylvania, USA., Kocis PT; Department of Pharmacy, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.; Department of Pharmacology, College of Medicine, Penn State University, Hershey, Pennsylvania, USA., Pichardo-Lowden A; Department of Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA., Hwang W; Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Journal of diabetes [J Diabetes] 2024 Oct; Vol. 16 (10), pp. e13604.
DOI: 10.1111/1753-0407.13604
Abstrakt: Background: Cardiovascular diseases are a common cause of death among patients with type 2 diabetes (T2DM). Major adverse cardiovascular event (MACE) risks can be significantly reduced under adequate glycemic control (GC). This study aims to identify factors that influence MACE risk among patients with T2DM, including Hemoglobin A1c variability score (HVS) and early use of MACE-preventive glucose-lowering medications (GLMs).
Methods: We conducted a longitudinal cohort study to retrospectively review electronic health records between 2011 and 2022. Patients with T2DM ≥18 years without previous stroke or acute myocardial infarction (AMI) were included. Cox regression was utilized to investigate MACE risk factors and compare MACE risk reduction associated with early use of MACE-preventive GLMs.
Results: A total of 19 685 subjects were included, with 5431 having MACE, including 4453 strokes, 977 AMI, and 1 death. There were 11 123 subjects with good baseline GC. Subjects with good baseline GC had 0.837 (confidence interval [CI]: 0.782-0.895) times lower MACE risk than their counterpart. Subjects with a single MACE-preventive GLM at baseline with continuous use >365 days showed a decreased MACE hazard ratio (0.681; CI: 0.635-0.731). Among all MACE-preventive GLMs, semaglutide provided a more significant MACE-preventive effect.
Conclusions: This study identified that GLM, early GC, and HVS are MACE determinants among patients with T2DM. Novel GLM, adequate GC, and reduction of HVS can benefit MACE outcomes.
(© 2024 The Author(s). Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje