Risk for recurrent cardiovascular disease events among patients with diabetes and chronic kidney disease

Cardiovascular Diabetology

Stephanie Reading¹  Kate K. Orroth¹  Demetria Hubbard²  Lei Huang²  Orlando M. Gutierrez²  Lisandro D. Colantonio²  Paul Muntner²  Vera Bittner³  Elizabeth A. Jackson³  Todd M. Brown³  Robert S. Rosenson⁴  Michael E. Farkouh⁵  Mark Woodward⁶  Monika M. Safford⁷ 

[1] Center for Observational Research, Amgen Inc.;Department of Epidemiology, University of Alabama At Birmingham;Department of Medicine, Division of Cardiovascular Disease, University of Alabama At Birmingham;Mount Sinai Heart, Icahn School of Medicine At Mount Sinai;Peter Munk Cardiac Centre, University of Toronto and Heart and Stroke Richard Lewar Centre of Excellence;The George Institute for Global Health, Imperial College;Weill Cornell Medical College, Cornell University;

关键词: Cardiovascular disease;    Chronic kidney disease;    Diabetes;    Myocardial infarction;    Risk factors;    Epidemiology;   

DOI  :  10.1186/s12933-021-01247-0

来源: DOAJ

【 摘 要 】

Abstract Background Adults who have experienced multiple cardiovascular disease (CVD) events have a very high risk for additional events. Diabetes and chronic kidney disease (CKD) are each associated with an increased risk for recurrent CVD events following a myocardial infarction (MI). Methods We compared the risk for recurrent CVD events among US adults with health insurance who were hospitalized for an MI between 2014 and 2017 and had (1) CVD prior to their MI but were free from diabetes or CKD (prior CVD), and those without CVD prior to their MI who had (2) diabetes only, (3) CKD only and (4) both diabetes and CKD. We followed patients from hospital discharge through December 31, 2018 for recurrent CVD events including coronary, stroke, and peripheral artery events. Results Among 162,730 patients, 55.2% had prior CVD, and 28.3%, 8.3%, and 8.2% had diabetes only, CKD only, and both diabetes and CKD, respectively. The rate for recurrent CVD events per 1000 person-years was 135 among patients with prior CVD and 110, 124 and 171 among those with diabetes only, CKD only and both diabetes and CKD, respectively. Compared to patients with prior CVD, the multivariable-adjusted hazard ratio for recurrent CVD events was 0.92 (95%CI 0.90–0.95), 0.89 (95%CI: 0.85–0.93), and 1.18 (95%CI: 1.14–1.22) among those with diabetes only, CKD only, and both diabetes and CKD, respectively. Conclusion Following MI, adults with both diabetes and CKD had a higher risk for recurrent CVD events compared to those with prior CVD without diabetes or CKD.

【 授权许可】

Unknown