Cardiovascular events and mortality in people with type 2 diabetes and multimorbidity: A real-world study of patients followed for up to 19 years.
Diabetes Obes Metab
; 23(1): 218-227, 2021 01.
Article
en En
| MEDLINE
| ID: mdl-33026165
ABSTRACT
AIM:
To quantify the risk of cardiovascular disease (CVD) events, all-cause mortality and cardiovascular mortality in patients diagnosed with type 2 diabetes (T2D) and multimorbidity.METHODS:
This retrospective study used English primary and secondary care data to identify 120 409 adults newly diagnosed with T2D during 2000-2018 with follow-up until death or 31 December 2018. Patients were classified according to the level and type of multimorbidity at T2D diagnosis, and adjusted hazard ratios (aHRs) were calculated for each outcome.RESULTS:
In total, 66 977 (55.6%) patients had T2D only, 37 894 (31.5%) had one co-morbidity, 11 357 (9.4%) had two co-morbidities, 3186 (2.6%) patients had three co-morbidities and 995 (0.8%) patients had four or more co-morbidities. Co-morbidities were associated with increased aHRs for all outcomes. Compared with patients with T2D only, at 19 years after diagnosis of T2D the aHR for four or more co-morbidities was 2.57 (95% CI 2.45-2.69) for a CVD event, 1.73 (1.68-1.78) for all-cause mortality and 2.68 (2.52-2.85) for cardiovascular mortality. Also, 100 183 (83.2%) patients had no CVD co-morbidities, 16 874 (14.0%) patients had one CVD co-morbidity and 3352 (2.8%) patients had two or more co-morbidities. Compared with patients with no CVD co-morbidities, at 19 years after diagnosis of T2D the aHR for two or more CVD co-morbidities was 2.42 (2.35-2.49) for a CVD event, 1.44 (1.42-1.47) for all-cause mortality and 2.44 (2.35-2.54) for cardiovascular mortality.CONCLUSION:
In people with T2D, level of multimorbidity and, in particular, CVD multimorbidity increased the risk of subsequent CVD events, mortality and cardiovascular mortality.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Enfermedades Cardiovasculares
/
Diabetes Mellitus Tipo 2
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
Idioma:
En
Revista:
Diabetes Obes Metab
Asunto de la revista:
ENDOCRINOLOGIA
/
METABOLISMO
Año:
2021
Tipo del documento:
Article
País de afiliación:
Reino Unido