PubMed ID:
33989668
Public Release Type:
Journal
Publication Year: 2021
Affiliation: Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA; Department of Medicine, Providence VA Medical Center and Alpert Medical School of Brown University, Providence, RI, USA; Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA; Welch Prevention Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
DOI:
https://doi.org/10.1016/j.diabres.2021.108859
Authors:
Erqou S,
Echouffo-Tcheugui J,
Bertoni A,
Kaze A,
Santhanam P,
Ahima R
Request IDs:
22606
Studies:
Look AHEAD: Action for Health in Diabetes
Aim: To evaluate the associations of microvascular disease (MVD) with incident cardiovascular disease (CVD) in individuals with type 2 diabetes. Methods: A total of 4098 participants with type 2 diabetes and without CVD were assessed for MVD (diabetic kidney disease, retinopathy or neuropathy) in the Look AHEAD (Action for Health in Diabetes) study. Cox models were used to generate hazard ratios (HRs) for: (1) CVD composite (myocardial infarction, stroke, hospitalization for angina and/or death from cardiovascular causes), (2) coronary artery disease (CAD), (3) stroke, and (4) CVD-related deaths. Results: Of 4098 participants, 34.7% (n= 1424) had MVD at baseline. Over a median of 9.5 years, 487 developed the CVD composite, 410 CAD events, 100 stroke, and 54 CVD-related deaths. After adjusting for relevant confounders, MVD was associated with increased risks of CVD composite (HR 1.34, 95% CI 1.11-1.61), CAD (HR 1.24, 95% CI 1.01-1.52), stroke (HR 1.55, 95% CI 1.03-2.33), and cardiovascular mortality (HR 1.26, 95% CI 0.72-2.22). HRs for CVD composite by type of MVD were 1.11 (95% CI 0.89-1.38), 1.63 (95% CI 1.22-2.17) and 1.16 (95% CI 0.92-1.46) for diabetic kidney disease, retinopathy, and neuropathy, respectively. Conclusions: Our findings underscore the relevance of MVD in CVD risk assessment in type 2 diabetes.