Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2021 Dec 4;21(1):579.
doi: 10.1186/s12872-021-02312-y.

Cardiovascular risk in patients with and without diabetes presenting with chronic coronary syndrome in 2004-2016

Esben Skov Jensen  1 , Kevin Kris Warnakula Olesen  1 , Christine Gyldenkerne  1 , Pernille Gro Thrane  1 , Lisette Okkels Jensen  2 , Bent Raungaard  3 , Per Løgstrup Poulsen  4 , Reimar Wernich Thomsen  5 , Michael Maeng  6
Affiliations
Comparative Study

Cardiovascular risk in patients with and without diabetes presenting with chronic coronary syndrome in 2004-2016

Esben Skov Jensen et al. BMC Cardiovasc Disord. .

Abstract

Background: It was recently shown that new-onset diabetes patients without previous cardiovascular disease have experienced a markedly reduced risk of adverse cardiovascular events from 1996 to 2011. However, it remains unknown if similar improvements are present following the diagnosis of chronic coronary syndrome. The purpose of this study was to examine the change in cardiovascular risk among diabetes patients with chronic coronary syndrome from 2004 to 2016.

Methods: We included patients with documentation of coronary artery disease by coronary angiography between 2004 and 2016 in Western Denmark. Patients were stratified by year of index coronary angiography (2004-2006, 2007-2009, 2010-2012, and 2013-2016) and followed for two years. The main outcome was major adverse cardiovascular events (MACE) defined as myocardial infarction, ischemic stroke, or death. Analyses were performed separately in patients with and without diabetes. We estimated two-year risk of each outcome and adjusted incidence rate ratios (aIRR) using patients examined in 2004-2006 as reference.

Results: Among 5931 patients with diabetes, two-year MACE risks were 8.4% in 2004-2006, 8.5% in 2007-2009, and then decreased to 6.2% in 2010-2012 and 6.7% in 2013-2016 (2013-2016 vs 2004-2006: aIRR 0.70, 95% CI 0.53-0.93). In comparison, 23,540 patients without diabetes had event rates of 6.3%, 5.2%, 4.2%, and 3.9% for the study intervals (2013-2016 vs 2004-2006: aIRR 0.57, 95% CI 0.48-0.68).

Conclusions: Between 2004 and 2016, the two-year relative risk of MACE decreased by 30% in patients with diabetes and chronic coronary syndrome, but slightly larger absolute and relative reductions were observed in patients without diabetes.

Keywords: Coronary artery disease; Diabetes; Major adverse cardiovascular event; Trend.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests. Department of Clinical Epidemiology is, however, involved in studies with funding from various companies as research grants to and administered by Aarhus University. None of these studies are related to the current study. Dr. Maeng has received advisory board fees from Boehringer-Ingelheim, AstraZeneca, Novo Nordisk, BMS, Boston Scientific, and Bayer.

Figures

Fig. 1
Fig. 1
Selection of patients with newly diagnosed chronic coronary syndrome determined by CAG from January 1, 2004, to December 31, 2016, in Western Denmark
Fig. 2
Fig. 2
Two-year risks of MACE with 95% confidence intervals (a) and adjusted IRR in non-diabetes (b) and in diabetes (c) patients from 2004 to 2016
See this image and copyright information in PMC

References

    1. Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358:580–591. doi: 10.1056/NEJMoa0706245. - DOI - PubMed
    1. Cosentino F, Grant PJ, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41:255–323. doi: 10.1093/eurheartj/ehz486. - DOI - PubMed
    1. Disease C, Management R. Standards of medical care in diabetes-2020. Diabetes Care. 2020;43(Supplement 1):S111–S134. doi: 10.2337/dc20-S010. - DOI - PubMed
    1. Effect of intensive diabetes management on macrovascular events and risk factors in the Diabetes Control and Complications Trial. Am J Cardiol 1995;75:894–903. - PubMed
    1. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ 1998;317:703–13. - PMC - PubMed

Publication types

LinkOut - more resources