Incidence of cardiovascular events and vascular interventions in patients with type 2 diabetes
| Autor: | Maarten J. Cramer, Frank L.J. Visseren, Suzanne E Engelen, Yolanda van der Graaf, Gert J. de Borst, Manon C. Stam-Slob, Jan Westerink, L. Jaap Kappelle, Diederick E. Grobbee |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Population Type 2 diabetes 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Internal medicine Diabetes mellitus Humans Medicine Prospective Studies 030212 general & internal medicine Myocardial infarction Coronary Artery Bypass Risk factor education Interventions Aged Netherlands education.field_of_study business.industry Vascular disease Incidence Incidence (epidemiology) Angioplasty Percutaneous coronary intervention Middle Aged medicine.disease Cardiovascular disease Diabetes Mellitus Type 2 Cardiovascular Diseases Cardiology Female Stents Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | International Journal of Cardiology, 248, 301. Elsevier Ireland Ltd |
| ISSN: | 0167-5273 |
| Popis: | Objective Diabetes mellitus is associated with an increased risk for cardiovascular morbidity and mortality. The vascular burden in terms of incidence of cardiovascular events (CVE) and vascular interventions is however poorly quantified. In this study we evaluated the incidence rates of CVE and vascular interventions in patients with type 2 diabetes (T2DM) with and without cardiovascular disease (CVD) in comparison to patients without type 2 diabetes. Research design and methods In a cohort of 9.808 high-risk patients with and without cardiovascular disease and type 2 diabetes originated from the ongoing, single-center prospective SMART (Second Manifestations of ARTerial disease) cohort, the number and incidence rates of CVE and interventions were calculated. The incidence rates were adjusted for confounders using Poisson regression models. CVE were defined as vascular death, stroke and myocardial infarction (MI). Interventions were defined as percutaneous coronary intervention, coronary artery bypass grafting, percutaneous transluminal angioplasty or stenting of the peripheral arteries and amputation. Results Patients with T2DM and CVD had a 4-fold higher incidence rate of CVE and a 8-fold higher incidence rate of vascular interventions compared to high-risk patients without T2DM and CVD after adjusting for confounders. The incidence rate for the composite of non-fatal MI, non-fatal stroke and vascular death was 5.8 per 1000person-years in patients without T2DM or CVD at baseline, 15.2 per 1000person-years in patients with T2DM but without CVD at baseline, 26.0 per 1000person-years in patients without T2DM but with CVD and 40.7 per 1000person-years in patients with both T2DM and CVD at baseline. A similar increasing incidence rate was seen for all vascular interventions from patients without T2DM or CVD to patients with both T2DM and CVD. Conclusions Patients with type 2 diabetes or CVD are subject to an increased incidence of cardiovascular events and interventions compared to high-risk patients without type 2 diabetes or vascular disease. Patients with type 2 diabetes and CVD have the highest incidence of new cardiovascular diseases and vascular interventions when compared to patients without type 2 diabetes and CVD. These results underline the need for optimal risk factor treatment as well as the need for new prevention and treatment strategies in this very high risk population. |
| Databáze: | OpenAIRE |
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