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

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 c...

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Autores principales:	Esben Skov Jensen, Kevin Kris Warnakula Olesen, Christine Gyldenkerne, Pernille Gro Thrane, Lisette Okkels Jensen, Bent Raungaard, Per Løgstrup Poulsen, Reimar Wernich Thomsen, Michael Maeng
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Diabetes Coronary artery disease Major adverse cardiovascular event Trend Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/3457b80406c248079fbc753f99fc934f
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spelling	oai:doaj.org-article:3457b80406c248079fbc753f99fc934f2021-12-05T12:05:15ZCardiovascular risk in patients with and without diabetes presenting with chronic coronary syndrome in 2004–201610.1186/s12872-021-02312-y1471-2261https://doaj.org/article/3457b80406c248079fbc753f99fc934f2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12872-021-02312-yhttps://doaj.org/toc/1471-2261Abstract 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.Esben Skov JensenKevin Kris Warnakula OlesenChristine GyldenkernePernille Gro ThraneLisette Okkels JensenBent RaungaardPer Løgstrup PoulsenReimar Wernich ThomsenMichael MaengBMCarticleDiabetesCoronary artery diseaseMajor adverse cardiovascular eventTrendDiseases of the circulatory (Cardiovascular) systemRC666-701ENBMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diabetes Coronary artery disease Major adverse cardiovascular event Trend Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diabetes Coronary artery disease Major adverse cardiovascular event Trend Diseases of the circulatory (Cardiovascular) system RC666-701 Esben Skov Jensen Kevin Kris Warnakula Olesen Christine Gyldenkerne Pernille Gro Thrane Lisette Okkels Jensen Bent Raungaard Per Løgstrup Poulsen Reimar Wernich Thomsen Michael Maeng Cardiovascular risk in patients with and without diabetes presenting with chronic coronary syndrome in 2004–2016
description	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.
format	article
author	Esben Skov Jensen Kevin Kris Warnakula Olesen Christine Gyldenkerne Pernille Gro Thrane Lisette Okkels Jensen Bent Raungaard Per Løgstrup Poulsen Reimar Wernich Thomsen Michael Maeng
author_facet	Esben Skov Jensen Kevin Kris Warnakula Olesen Christine Gyldenkerne Pernille Gro Thrane Lisette Okkels Jensen Bent Raungaard Per Løgstrup Poulsen Reimar Wernich Thomsen Michael Maeng
author_sort	Esben Skov Jensen
title	Cardiovascular risk in patients with and without diabetes presenting with chronic coronary syndrome in 2004–2016
title_short	Cardiovascular risk in patients with and without diabetes presenting with chronic coronary syndrome in 2004–2016
title_full	Cardiovascular risk in patients with and without diabetes presenting with chronic coronary syndrome in 2004–2016
title_fullStr	Cardiovascular risk in patients with and without diabetes presenting with chronic coronary syndrome in 2004–2016
title_full_unstemmed	Cardiovascular risk in patients with and without diabetes presenting with chronic coronary syndrome in 2004–2016
title_sort	cardiovascular risk in patients with and without diabetes presenting with chronic coronary syndrome in 2004–2016
publisher	BMC
publishDate	2021
url	https://doaj.org/article/3457b80406c248079fbc753f99fc934f
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Cardiovascular risk in patients with and without diabetes presenting with chronic coronary syndrome in 2004–2016

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