Duration of type 2 diabetes strongly predicts all-cause and cardiovascular mortality in people referred for coronary angiography

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• 作者：Guenther Silbernagel^a ; ^b ; Silke Rosinger^c ; Tanja B. Grammer^d ; Marcus E. Kleber^a ; Bernhard R. Winkelmann^e ; Bernhard O. Boehm^c ; Winfried Mä ; rz^d ; ^f ; ^g ; ^{winfried.maerz@synlab.de}
• 关键词：Duration of type 2 diabetes ; All-cause mortality ; Cardiovascular mortality
• 刊名：Atherosclerosis
• 出版年：2012
• 出版时间：April, 2012
• 年：2012
• 卷：221
• 期：2
• 页码：551-557
• 全文大小：360 K

文摘

Objective

Type 2 diabetes represents a major cardiovascular risk factor. However, few studies have addressed the impact of the disease duration on mortality. Thus, we aimed to investigate the predictive value of diabetes duration for all-cause and cardiovascular mortality in subjects undergoing coronary angiography.

Methods

We studied 2455 participants of the LUdwigshafen RIsk and Cardiovascular health study (1768 males/687 females). They had a mean ¡À standard deviation (SD) age of 63.1 ¡À 9.0 years (range: 40.0-79.9) and a mean ¡À SD body mass index of 27.7 ¡À 4.0 kg/m². 704 subjects were newly diagnosed with type 2 diabetes according to the 2010 criteria of the American Diabetes Association and 446 subjects had a known history of type 2 diabetes. The mean ¡À SD duration of the follow-up for all-cause and cardiovascular mortality was 7.4 ¡À 2.3 years.

Results

A total of 543 deaths occurred during the follow-up. Among these, 343 were accounted for by cardiovascular diseases. The duration of type 2 diabetes was strongly and positively correlated with all-cause and cardiovascular mortality (both P < 0.001). The multivariate adjusted hazard ratios (95 % confidence intervals) for cardiovascular mortality compared to subjects without diabetes were 1.76 (1.34-2.32), 2.86 (2.00-4.08), 2.96 (1.85-4.74), and 4.55 (3.24-6.39) for subjects with new onset type 2 diabetes and subjects with known type 2 diabetes (duration ?, >5 and ?0, >10 years), respectively.

Conclusions

The data emphasise the need to consider the diabetes duration for the prediction of mortality in subjects at intermediate to high cardiovascular risk.