Epidemiology of the first-ever cardiovascular event in people with type 1 diabetes: a retrospective cohort population-based study in Catalonia

Cardiovascular Diabetology

Research

Bogdan Vlacho¹  Jordi Real¹  Dídac Mauricio²  Manel Mata-Cases³  Josep Franch-Nadal⁴  Clara Viñals⁵  Emilio Ortega⁶  Gabriel Giménez-Pérez⁷ 

[1] DAP-Cat Group, Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, Barcelona, Spain;CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain;DAP-Cat Group, Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, Barcelona, Spain;CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain;Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;Department of Medicine, University of Vic - Central University of Catalonia, Vic, Spain;DAP-Cat Group, Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, Barcelona, Spain;CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain;Primary Health Care Center La Mina, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de La Salut, Sant Adrià de Besòs, Spain;DAP-Cat Group, Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, Barcelona, Spain;CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain;Primary Health Care Center Raval Sud, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de La Salut, Barcelona, Spain;Department of Endocrinology & Nutrition, Hospital Clínic de Barcelona, Barcelona, Spain;Department of Endocrinology & Nutrition, Hospital Clínic de Barcelona, Barcelona, Spain;DAP-Cat Group, Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, Barcelona, Spain;CIBER of Physiopathology of Obesity and Nutrition, ISCIII, Madrid, Spain;Section of Endocrinology, Department of Medicine, Hospital General de Granollers, Granollers, Spain;School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain;

关键词: Type-1 diabetes;    cardiovascular disease;    Peripheral vascular disease;    Ischemic heart disease;    Cerebrovascular disease;    Heart failure;   

DOI  :  10.1186/s12933-023-01917-1

 received in 2023-05-12, accepted in 2023-07-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundKnowledge of the characteristics of first-ever cardiovascular events in type 1 diabetes may impact primary prevention strategies. This study describes the first-ever manifestation of cardiovascular disease (CVD) in patients with type 1 diabetes (T1D) in Catalonia (Spain) and evaluates differences according to age and sex.MethodsRetrospective cohort study of patients with T1D > 30 years without CVD before 2010 registered in the SIDIAP database. The occurrence of a first cardiovascular event up to the end of 2016, the type of CV event and associations with baseline characteristics were analysed.ResultsOf 8412 patients, 884 suffered a first CV event (incidence rate 1.62 per 100 persons-years). Overall, peripheral vascular disease (39.5%) was the most frequent event. We observed a higher proportion of heart failure in women (21.7%) than in men (10.1%). In women, heart failure was the most frequent event in those > 65 years (40.5%). Decreased glomerular filtration rate (hazard ratio [HR] 5.42 [95% CI 4.32;6.80]), elevated albumin/creatinine ratio (HR 3.39 [95% CI [2.47;4.66], microvascular complications (HR 3.27 [95% CI 2.85;3.75]), and hypertension (HR 3.21 [95% CI [2.80;3.67]) were most strongly associated with a first CV event. HbA1c > 7.0% was associated with incident CVD only in patients aged < 55/60 years.ConclusionsPeripheral artery disease in the whole cohort, and heart failure in elder subjects are the most frequent first-ever CVD events in T1D in our region. These findings deserve to be taken into account when considering primary prevention measures and when estimating CV risk in people with T1D.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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