Single and combined effects of peripheral artery disease and of type 2 diabetes mellitus on the risk of cardiovascular events: A prospective cohort study.

Saely, Christoph H; Schindewolf, Marc; Zanolin, Daniela; Heinzle, Christine F; Vonbank, Alexander; Silbernagel, Guenther; Leiherer, Andreas; Drexel, Heinz; Baumgartner, Iris (2018). Single and combined effects of peripheral artery disease and of type 2 diabetes mellitus on the risk of cardiovascular events: A prospective cohort study. Atherosclerosis, 279, pp. 32-37. Elsevier 10.1016/j.atherosclerosis.2018.09.031

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BACKGROUND AND AIMS The individual and combined effects of type 2 diabetes (T2DM) and peripheral artery disease (PAD) on future cardiovascular events are unknown and are addressed in the present investigation. METHODS Cardiovascular events were prospectively recorded in 1049 subjects, encompassing 4 groups: 558 with neither PAD nor diabetes, 153 with T2DM but without PAD, 192 with PAD but without T2DM and 146 with the combination of PAD and T2DM. RESULTS Over a mean follow-up period of 7.2 ± 2.6 years, the cardiovascular event rate was lowest in patients with neither PAD nor T2DM (16.7%). Compared to this group the event rate was not significantly increased in T2DM patients without PAD (22.2%, p = 0.077) but higher in non-diabetic patients with PAD (52.6%; p < 0.001) and further increased in patients with both PAD and T2DM (71.2%; p < 0.001). Nondiabetic PAD patients were at a higher cardiovascular risk than T2DM patients without PAD (p < 0.001). Compared to those with neither PAD nor T2DM, hazard ratios after multivariate adjustment were 1.26 [0.84-1.91]; p = 0.267, 4.17 [2.97-5.85]; p < 0.001, and 7.82 [5.49-11.12]; p < 0.001 for those with T2DM only, for those with PAD only and for those with the combination of PAD plus diabetes, respectively. CONCLUSIONS PAD is a stronger risk factor for future cardiovascular events than T2DM, but T2DM in PAD patients accelerates atherothrombotic disease and strongly increases the incidence of cardiovascular events.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Schindewolf, Marc and Baumgartner, Iris

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0021-9150

Publisher:

Elsevier

Language:

English

Submitter:

Catherine Gut

Date Deposited:

11 Feb 2019 17:26

Last Modified:

11 Feb 2019 17:35

Publisher DOI:

10.1016/j.atherosclerosis.2018.09.031

PubMed ID:

30399464

Uncontrolled Keywords:

Atherosclerosis Cardiovascular disease Cohort analysis Peripheral artery disease Risk factors Type 2 diabetes

BORIS DOI:

10.7892/boris.123380

URI:

https://boris.unibe.ch/id/eprint/123380

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