Extent of coronary artery disease is associated with myocardial infarction and mortality in patients with diabetes mellitus

Christine Gyldenkerne; Kevin Kris Warnakula Olesen; Morten Madsen; Troels Thim; Lisette Okkels Jensen; Bent Raungaard; Henrik Toft Sørensen; Hans Erik Bøtker; Michael Maeng

doi:10.2147/CLEP.S200173

Extent of coronary artery disease is associated with myocardial infarction and mortality in patients with diabetes mellitus

Christine Gyldenkerne
, Kevin Kris Warnakula Olesen
, Morten Madsen
, Troels Thim
, Lisette Okkels Jensen
, Bent Raungaard
, Henrik Toft Sørensen
, Hans Erik Bøtker
, Michael Maeng^*

^*Kontaktforfatter

KI, OUH, Forskningsenhed for Kardiologi (Odense)

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

94 Downloads (Pure)

Abstract

Purpose: We examined risk of myocardial infarction and all-cause death associated with the extent of coronary artery disease ascertained by coronary angiography in patients with diabetes mellitus. We hypothesized that risks of myocardial infarction and death were associated with extent of coronary artery disease in diabetes patients. Patients and methods: We conducted a cohort study of patientswith type 1 and type 2 diabetes, who underwent coronary angiography from 2004 to 2012. Patients were stratified according to extent of coronary artery disease: 0-, 1-, 2- or 3-vessel disease or diffuse vessel disease. Endpoints were myocardial infarction, all-cause death, and major adverse cardiovascular events (MACE), defined as the composite of myocardial infarction, cardiac death, or ischemic stroke. Adjusted incidence and mortality rate ratios (IRRsadj) were calculated using patients with 0-vessel disease as the reference group. Median follow-up was 3 years for a total of 45,164 person-years. Results: The study included 12,594 diabetes patients. Of these, 3,147 (25.0%) had 0-vessel disease, 1,195 (9.5%) had diffuse vessel disease, 3,001 (23.8%) had 1-vessel disease, 2,220 (17.6%) had 2-vessel disease, and 3,031 (24.1%) had 3-vessel disease. Themyocardial infarction rate was 0.4 per 100 person-years (95% CI: 0.3-0.5) in patients with 0-vessel disease. Using patients with 0-vessel disease as reference, the risk of myocardial infarction increased according to the number of diseased vessels (diffuse vessel disease: 1.4 per 100 person-years, IRRadj 3.87, 95% CI: 2.41-6.23; 1-vessel disease: 1.9 per 100 person-years, IRRadj 4.99, 95% CI: 3.33-7.46; 2-vessel disease: 2.7 per 100 person-years, IRRadj 7.14, 95% CI: 4.78-10.65; and 3-vessel disease: 4.3 per 100 person-years, IRRadj 11.42, 95% CI: 7.76-16.82; ptrend<0.001). Similar associations were observed for all-cause death and MACE. Conclusion: The extent of coronary artery disease is a major risk factor for myocardial infarction and death in patients with diabetes mellitus.

Originalsprog	Engelsk
Tidsskrift	Clinical Epidemiology
Vol/bind	11
Sider (fra-til)	419-428
ISSN	1179-1349
DOI	https://doi.org/10.2147/CLEP.S200173
Status	Udgivet - maj 2019

Finansiering

Dr Kevin Kris Warnakula Olesen reports personal fees from Bayer, outside the submitted work. Mr Madsen did not report receiving fees, honoraria, grants or consultancies; the Department of Clinical Epidemiology is, however, involved in studies with funding from various companies as research grants to (and administered by) Aarhus University. Dr Michael Maeng report personal fees from Bayer, personal fees from Novo Nordisk, personal fees from Bristol Myers-Squibb, personal fees from Astra, personal fees from Boehringer-Ingelheim, outside the submitted work. The other authors report no conflicts of interest in this work.

Dokumenter og links

10.2147/CLEP.S200173Licens: CC BY-NC

Open access versionForlagets udgivne version, 1,17 MBLicens: CC BY-NC

SDU link

Tjek adgangen til materialet i Syddansk Universitetsbiblioteks søgemaskine

Citationsformater

@article{150fe480204a4551b95e724f7969b402,

title = "Extent of coronary artery disease is associated with myocardial infarction and mortality in patients with diabetes mellitus",

abstract = "Purpose: We examined risk of myocardial infarction and all-cause death associated with the extent of coronary artery disease ascertained by coronary angiography in patients with diabetes mellitus. We hypothesized that risks of myocardial infarction and death were associated with extent of coronary artery disease in diabetes patients. Patients and methods: We conducted a cohort study of patientswith type 1 and type 2 diabetes, who underwent coronary angiography from 2004 to 2012. Patients were stratified according to extent of coronary artery disease: 0-, 1-, 2- or 3-vessel disease or diffuse vessel disease. Endpoints were myocardial infarction, all-cause death, and major adverse cardiovascular events (MACE), defined as the composite of myocardial infarction, cardiac death, or ischemic stroke. Adjusted incidence and mortality rate ratios (IRRsadj) were calculated using patients with 0-vessel disease as the reference group. Median follow-up was 3 years for a total of 45,164 person-years. Results: The study included 12,594 diabetes patients. Of these, 3,147 (25.0\%) had 0-vessel disease, 1,195 (9.5\%) had diffuse vessel disease, 3,001 (23.8\%) had 1-vessel disease, 2,220 (17.6\%) had 2-vessel disease, and 3,031 (24.1\%) had 3-vessel disease. Themyocardial infarction rate was 0.4 per 100 person-years (95\% CI: 0.3-0.5) in patients with 0-vessel disease. Using patients with 0-vessel disease as reference, the risk of myocardial infarction increased according to the number of diseased vessels (diffuse vessel disease: 1.4 per 100 person-years, IRRadj 3.87, 95\% CI: 2.41-6.23; 1-vessel disease: 1.9 per 100 person-years, IRRadj 4.99, 95\% CI: 3.33-7.46; 2-vessel disease: 2.7 per 100 person-years, IRRadj 7.14, 95\% CI: 4.78-10.65; and 3-vessel disease: 4.3 per 100 person-years, IRRadj 11.42, 95\% CI: 7.76-16.82; ptrend<0.001). Similar associations were observed for all-cause death and MACE. Conclusion: The extent of coronary artery disease is a major risk factor for myocardial infarction and death in patients with diabetes mellitus.",

keywords = "Coronary angiography, Death, Epidemiology, Western denmark heart registry",

author = "Christine Gyldenkerne and Olesen, \{Kevin Kris Warnakula\} and Morten Madsen and Troels Thim and Jensen, \{Lisette Okkels\} and Bent Raungaard and S{\o}rensen, \{Henrik Toft\} and B{\o}tker, \{Hans Erik\} and Michael Maeng",

year = "2019",

month = may,

doi = "10.2147/CLEP.S200173",

language = "English",

volume = "11",

pages = "419--428",

journal = "Clinical Epidemiology",

issn = "1179-1349",

publisher = "Dove Medical Press",

}

TY - JOUR

T1 - Extent of coronary artery disease is associated with myocardial infarction and mortality in patients with diabetes mellitus

AU - Gyldenkerne, Christine

AU - Olesen, Kevin Kris Warnakula

AU - Madsen, Morten

AU - Thim, Troels

AU - Jensen, Lisette Okkels

AU - Raungaard, Bent

AU - Sørensen, Henrik Toft

AU - Bøtker, Hans Erik

AU - Maeng, Michael

PY - 2019/5

Y1 - 2019/5

N2 - Purpose: We examined risk of myocardial infarction and all-cause death associated with the extent of coronary artery disease ascertained by coronary angiography in patients with diabetes mellitus. We hypothesized that risks of myocardial infarction and death were associated with extent of coronary artery disease in diabetes patients. Patients and methods: We conducted a cohort study of patientswith type 1 and type 2 diabetes, who underwent coronary angiography from 2004 to 2012. Patients were stratified according to extent of coronary artery disease: 0-, 1-, 2- or 3-vessel disease or diffuse vessel disease. Endpoints were myocardial infarction, all-cause death, and major adverse cardiovascular events (MACE), defined as the composite of myocardial infarction, cardiac death, or ischemic stroke. Adjusted incidence and mortality rate ratios (IRRsadj) were calculated using patients with 0-vessel disease as the reference group. Median follow-up was 3 years for a total of 45,164 person-years. Results: The study included 12,594 diabetes patients. Of these, 3,147 (25.0%) had 0-vessel disease, 1,195 (9.5%) had diffuse vessel disease, 3,001 (23.8%) had 1-vessel disease, 2,220 (17.6%) had 2-vessel disease, and 3,031 (24.1%) had 3-vessel disease. Themyocardial infarction rate was 0.4 per 100 person-years (95% CI: 0.3-0.5) in patients with 0-vessel disease. Using patients with 0-vessel disease as reference, the risk of myocardial infarction increased according to the number of diseased vessels (diffuse vessel disease: 1.4 per 100 person-years, IRRadj 3.87, 95% CI: 2.41-6.23; 1-vessel disease: 1.9 per 100 person-years, IRRadj 4.99, 95% CI: 3.33-7.46; 2-vessel disease: 2.7 per 100 person-years, IRRadj 7.14, 95% CI: 4.78-10.65; and 3-vessel disease: 4.3 per 100 person-years, IRRadj 11.42, 95% CI: 7.76-16.82; ptrend<0.001). Similar associations were observed for all-cause death and MACE. Conclusion: The extent of coronary artery disease is a major risk factor for myocardial infarction and death in patients with diabetes mellitus.

AB - Purpose: We examined risk of myocardial infarction and all-cause death associated with the extent of coronary artery disease ascertained by coronary angiography in patients with diabetes mellitus. We hypothesized that risks of myocardial infarction and death were associated with extent of coronary artery disease in diabetes patients. Patients and methods: We conducted a cohort study of patientswith type 1 and type 2 diabetes, who underwent coronary angiography from 2004 to 2012. Patients were stratified according to extent of coronary artery disease: 0-, 1-, 2- or 3-vessel disease or diffuse vessel disease. Endpoints were myocardial infarction, all-cause death, and major adverse cardiovascular events (MACE), defined as the composite of myocardial infarction, cardiac death, or ischemic stroke. Adjusted incidence and mortality rate ratios (IRRsadj) were calculated using patients with 0-vessel disease as the reference group. Median follow-up was 3 years for a total of 45,164 person-years. Results: The study included 12,594 diabetes patients. Of these, 3,147 (25.0%) had 0-vessel disease, 1,195 (9.5%) had diffuse vessel disease, 3,001 (23.8%) had 1-vessel disease, 2,220 (17.6%) had 2-vessel disease, and 3,031 (24.1%) had 3-vessel disease. Themyocardial infarction rate was 0.4 per 100 person-years (95% CI: 0.3-0.5) in patients with 0-vessel disease. Using patients with 0-vessel disease as reference, the risk of myocardial infarction increased according to the number of diseased vessels (diffuse vessel disease: 1.4 per 100 person-years, IRRadj 3.87, 95% CI: 2.41-6.23; 1-vessel disease: 1.9 per 100 person-years, IRRadj 4.99, 95% CI: 3.33-7.46; 2-vessel disease: 2.7 per 100 person-years, IRRadj 7.14, 95% CI: 4.78-10.65; and 3-vessel disease: 4.3 per 100 person-years, IRRadj 11.42, 95% CI: 7.76-16.82; ptrend<0.001). Similar associations were observed for all-cause death and MACE. Conclusion: The extent of coronary artery disease is a major risk factor for myocardial infarction and death in patients with diabetes mellitus.

KW - Coronary angiography

KW - Death

KW - Epidemiology

KW - Western denmark heart registry

U2 - 10.2147/CLEP.S200173

DO - 10.2147/CLEP.S200173

M3 - Journal article

C2 - 31191034

AN - SCOPUS:85071142237

SN - 1179-1349

VL - 11

SP - 419

EP - 428

JO - Clinical Epidemiology

JF - Clinical Epidemiology

ER -

Extent of coronary artery disease is associated with myocardial infarction and mortality in patients with diabetes mellitus

Abstract

Finansiering

Dokumenter og links

SDU link

Fingeraftryk

Citationsformater