TY - JOUR
T1 - Microvascular disease and cardiovascular outcomes among individuals with type 2 diabetes
AU - Kaze, Arnaud D.
AU - Santhanam, Prasanna
AU - Erqou, Sebhat
AU - Bertoni, Alain G.
AU - Ahima, Rexford S.
AU - Echouffo-Tcheugui, Justin B.
N1 - Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/6
Y1 - 2021/6
N2 - Aim: To evaluate the associations of microvascular disease (MVD) with incident cardiovascular disease (CVD) in individuals with type 2 diabetes. Methods: A total of 4098 participants with type 2 diabetes and without CVD were assessed for MVD (diabetic kidney disease, retinopathy or neuropathy) in the Look AHEAD (Action for Health in Diabetes) study. Cox models were used to generate hazard ratios (HRs) for: (1) CVD composite (myocardial infarction, stroke, hospitalization for angina and/or death from cardiovascular causes), (2) coronary artery disease (CAD), (3) stroke, and (4) CVD-related deaths. Results: Of 4098 participants, 34.7% (n = 1424) had MVD at baseline. Over a median of 9.5 years, 487 developed the CVD composite, 410 CAD events, 100 stroke, and 54 CVD-related deaths. After adjusting for relevant confounders, MVD was associated with increased risks of CVD composite (HR 1.34, 95% CI 1.11–1.61), CAD (HR 1.24, 95% CI 1.01–1.52), stroke (HR 1.55, 95% CI 1.03–2.33), and cardiovascular mortality (HR 1.26, 95% CI 0.72–2.22). HRs for CVD composite by type of MVD were 1.11 (95% CI 0.89–1.38), 1.63 (95% CI 1.22–2.17) and 1.16 (95% CI 0.92–1.46) for diabetic kidney disease, retinopathy, and neuropathy, respectively. Conclusions: Our findings underscore the relevance of MVD in CVD risk assessment in type 2 diabetes.
AB - Aim: To evaluate the associations of microvascular disease (MVD) with incident cardiovascular disease (CVD) in individuals with type 2 diabetes. Methods: A total of 4098 participants with type 2 diabetes and without CVD were assessed for MVD (diabetic kidney disease, retinopathy or neuropathy) in the Look AHEAD (Action for Health in Diabetes) study. Cox models were used to generate hazard ratios (HRs) for: (1) CVD composite (myocardial infarction, stroke, hospitalization for angina and/or death from cardiovascular causes), (2) coronary artery disease (CAD), (3) stroke, and (4) CVD-related deaths. Results: Of 4098 participants, 34.7% (n = 1424) had MVD at baseline. Over a median of 9.5 years, 487 developed the CVD composite, 410 CAD events, 100 stroke, and 54 CVD-related deaths. After adjusting for relevant confounders, MVD was associated with increased risks of CVD composite (HR 1.34, 95% CI 1.11–1.61), CAD (HR 1.24, 95% CI 1.01–1.52), stroke (HR 1.55, 95% CI 1.03–2.33), and cardiovascular mortality (HR 1.26, 95% CI 0.72–2.22). HRs for CVD composite by type of MVD were 1.11 (95% CI 0.89–1.38), 1.63 (95% CI 1.22–2.17) and 1.16 (95% CI 0.92–1.46) for diabetic kidney disease, retinopathy, and neuropathy, respectively. Conclusions: Our findings underscore the relevance of MVD in CVD risk assessment in type 2 diabetes.
KW - Cardiovascular disease
KW - Diabetes
KW - Microvascular disease
KW - Mortality
UR - http://www.scopus.com/inward/record.url?scp=85107797478&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107797478&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2021.108859
DO - 10.1016/j.diabres.2021.108859
M3 - Article
C2 - 33989668
AN - SCOPUS:85107797478
SN - 0168-8227
VL - 176
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 108859
ER -