Coles, Briana; Zaccardi, Francesco; Ling, Suping; Davies, Melanie J; Samani, Nilesh J; Khunti, Kamlesh; (2020) Cardiovascular events and mortality in people with and without type 2 diabetes: An observational study in a contemporary multi-ethnic population. Journal of Diabetes Investigation (JDI), 12 (7). pp. 1175-1182. ISSN 2040-1116 DOI: https://doi.org/10.1111/jdi.13464
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Abstract
AIMS/INTRODUCTION: The aim of this study was to examine ethnicity-specific associations between type 2 diabetes mellitus and the risk of a cardiovascular disease (CVD) event as well as risk of specific CVD phenotypes in England. METHODS: We obtained data from the Clinical Practice Research Datalink for adults with and without type 2 diabetes mellitus diagnosed 2000-2006. The outcome was the first CVD event during 2007-2017 and the following components: aortic aneurysm, cerebrovascular accidents, heart failure, myocardial infarction, peripheral vascular disease and other CVD-related conditions. Flexible parametric survival models were used to estimate ethnicity-specific adjusted hazard ratios. RESULTS: A total of 734,543 people with and without type 2 diabetes mellitus (29,847; 4.1%) were included; most were of white ethnicity (93.0% with and 92.3% without type 2 diabetes mellitus) followed by South Asian (3.2 and 4.6%). During a median follow-up period of 11.0 years, 67,218 events occurred (6,156 in individuals with type 2 diabetes mellitus). Type 2 diabetes mellitus was associated with a small increase in CVD events (adjusted hazard ratio 1.06, 95% confidence interval 1.02-1.09) in individuals of white ethnicity; whereas the adjusted hazard ratios were considerably higher in individuals of South Asian ethnicity (1.28, 95% confidence interval 1.09-1.51), primarily due to an increased risk of myocardial infarction (1.53, 95% confidence interval 1.08-2.18). CONCLUSIONS: Despite universal access to healthcare, there are large disparities in CVD outcomes in people with and without type 2 diabetes mellitus. Other non-traditional risk factors might play a role in the higher CVD risk associated with type 2 diabetes mellitus in individuals of South Asian ethnicity.
Item Type | Article |
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Faculty and Department | Faculty of Public Health and Policy > Dept of Health Services Research and Policy |
PubMed ID | 33206469 |
Elements ID | 164375 |
Official URL | https://doi.org/10.1111/jdi.13464 |
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Filename: Coles-etal-2020-Cardiovascular-events-and-mortality-in-people-with-and-without-type-2-diabetes-An-observational-study-in-a-contemporary-multi-ethnic-population.pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
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