Clinical cardiovascular phenotypes and the pattern of future events in patients with type 2 diabetes
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Clinical cardiovascular phenotypes and the pattern of future events in patients with type 2 diabetes. / Malik, Mariam Elmegaard; Andersson, Charlotte; Blanche, Paul; D'Souza, Maria; Madelaire, Christian; Zareini, Bochra; Lamberts, Morten; Kristensen, Soren Lund; Sattar, Naveed; McMurray, John; Køber, Lars; Torp-Pedersen, Christian; Gislason, Gunnar; Schou, Morten.
In: Clinical Research in Cardiology, Vol. 112, 2023, p. 215-226.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Clinical cardiovascular phenotypes and the pattern of future events in patients with type 2 diabetes
AU - Malik, Mariam Elmegaard
AU - Andersson, Charlotte
AU - Blanche, Paul
AU - D'Souza, Maria
AU - Madelaire, Christian
AU - Zareini, Bochra
AU - Lamberts, Morten
AU - Kristensen, Soren Lund
AU - Sattar, Naveed
AU - McMurray, John
AU - Køber, Lars
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar
AU - Schou, Morten
PY - 2023
Y1 - 2023
N2 - Importance Updated guidelines on diabetes recommend targeting sodium-glucose cotransporter-2 inhibitors (SGLT2i) at patients at risk of heart failure (HF) and glucagon-like peptide-1 receptor agonists (GLP1-RA) at those at greater risk of atherothrombotic events.Objective We estimated the risk of different cardiovascular events in patients with type 2 diabetes (T2D) and newly established cardiovascular disease.Design, setting and participants Patients with T2D and newly established cardiovascular disease from 1998 to 2016 were identified using Danish healthcare registers and divided into one of four phenotype groups: (1) HF, (2) ischemic heart disease (IHD), (3) transient ischemic stroke (TIA)/ischemic stroke, and (4) peripheral artery disease (PAD). The absolute 5-year risk of the first HF- or atherothrombotic event occurring after inclusion was calculated, along with the risk of death.Main outcomes and measures The main outcome was the first event of either HF or an atherothrombotic event (IHD, TIA/ischemic stroke or PAD) in patients with T2D and new-onset cardiovascular disease.Results Of the 37,850 patients included, 40% were female and the median age was 70 years. Patients with HF were at higher 5-year risk of a subsequent HF event (17.9%; 95% confidence interval (CI) 17.1-18.8%) than an atherothrombotic event (15.8%; 15.0-16.6%). Patients with IHD were at higher risk of a subsequent atherothrombotic event (24.6%; 23.9-25.3%) than developing HF, although the risk of HF was still substantial (10.6%; 10.2-11.1%). Conversely, patients with PAD were at low risk of developing HF (4.4%; 3.8-5.1%) but at high risk of developing an atherothrombotic event (15.9%; 14.9-17.1%). Patients with TIA/ischemic stroke had the lowest risk of HF (3.2%; 2.9-3.6%) and the highest risk of an atherothrombotic event (20.6%; 19.8-21.4).Conclusions In T2D, a patient's cardiovascular phenotype can help predict the pattern of future cardiovascular events.[GRAPHICS].
AB - Importance Updated guidelines on diabetes recommend targeting sodium-glucose cotransporter-2 inhibitors (SGLT2i) at patients at risk of heart failure (HF) and glucagon-like peptide-1 receptor agonists (GLP1-RA) at those at greater risk of atherothrombotic events.Objective We estimated the risk of different cardiovascular events in patients with type 2 diabetes (T2D) and newly established cardiovascular disease.Design, setting and participants Patients with T2D and newly established cardiovascular disease from 1998 to 2016 were identified using Danish healthcare registers and divided into one of four phenotype groups: (1) HF, (2) ischemic heart disease (IHD), (3) transient ischemic stroke (TIA)/ischemic stroke, and (4) peripheral artery disease (PAD). The absolute 5-year risk of the first HF- or atherothrombotic event occurring after inclusion was calculated, along with the risk of death.Main outcomes and measures The main outcome was the first event of either HF or an atherothrombotic event (IHD, TIA/ischemic stroke or PAD) in patients with T2D and new-onset cardiovascular disease.Results Of the 37,850 patients included, 40% were female and the median age was 70 years. Patients with HF were at higher 5-year risk of a subsequent HF event (17.9%; 95% confidence interval (CI) 17.1-18.8%) than an atherothrombotic event (15.8%; 15.0-16.6%). Patients with IHD were at higher risk of a subsequent atherothrombotic event (24.6%; 23.9-25.3%) than developing HF, although the risk of HF was still substantial (10.6%; 10.2-11.1%). Conversely, patients with PAD were at low risk of developing HF (4.4%; 3.8-5.1%) but at high risk of developing an atherothrombotic event (15.9%; 14.9-17.1%). Patients with TIA/ischemic stroke had the lowest risk of HF (3.2%; 2.9-3.6%) and the highest risk of an atherothrombotic event (20.6%; 19.8-21.4).Conclusions In T2D, a patient's cardiovascular phenotype can help predict the pattern of future cardiovascular events.[GRAPHICS].
KW - Heart failure
KW - Cardiovascular disease
KW - Type 2 diabetes
KW - Epidemiology
KW - CIVIL REGISTRATION SYSTEM
KW - HEART-FAILURE DIAGNOSIS
KW - MYOCARDIAL-INFARCTION
KW - ISCHEMIC-STROKE
KW - RISK
KW - MORTALITY
KW - LIRAGLUTIDE
KW - OUTCOMES
KW - THERAPY
KW - DISEASE
U2 - 10.1007/s00392-022-02016-z
DO - 10.1007/s00392-022-02016-z
M3 - Journal article
C2 - 35396632
VL - 112
SP - 215
EP - 226
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
SN - 1861-0684
ER -
ID: 303959830