The effect of deep vein thrombosis on major adverse limb events in diabetic patients: a nationwide retrospective cohort study

Abstract Little is known about the association between deep vein thrombosis (DVT) and arterial complications in patients with type 2 diabetes (T2DM). The aim of this retrospective cohort study was to assess the influence of prior DVT on major adverse limb events (MALEs) and major adverse cardiovascu...

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Autores principales:	Po-Chang Wang, Tien-Hsing Chen, Chang-Min Chung, Mei-Yen Chen, Jung-Jung Chang, Yu-Sheng Lin, Pao-Hsien Chu, Yun-Shing Peng, Ming-Shyan Lin
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/58c42ebd677b4dafaccf56a03803ca8c
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spelling	oai:doaj.org-article:58c42ebd677b4dafaccf56a03803ca8c2021-12-02T14:27:46ZThe effect of deep vein thrombosis on major adverse limb events in diabetic patients: a nationwide retrospective cohort study10.1038/s41598-021-87461-y2045-2322https://doaj.org/article/58c42ebd677b4dafaccf56a03803ca8c2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87461-yhttps://doaj.org/toc/2045-2322Abstract Little is known about the association between deep vein thrombosis (DVT) and arterial complications in patients with type 2 diabetes (T2DM). The aim of this retrospective cohort study was to assess the influence of prior DVT on major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) in T2DM. A total of 1,628,675 patients with T2DM with or without a history of DVT from 2001 to 2013 were identified in the National Health Insurance Research Database of Taiwan. Before matching, the patients in the DVT group (n = 2020) were older than the control group (66.3 vs. 58.3 years). Patients in the DVT group were more likely to be female than the control group (54.3% vs. 47.5%). Before matching, the DVT group had higher prevalence of most comorbidities, more prescription of antiplatelet, antihypertensive agents and insulins, but less prescription of metformin and sulfonylurea. During a mean follow-up of 5.2 years (standard deviation: 3.9 years), the matched DVT group (n = 2017) have a significantly increased risk of MALE (8.4% vs. 5.2%; subdistribution hazard ratio [SHR] 1.60, 95% CI 1.34–1.90), foot ulcer (5.2% vs. 2.6%, SHR 1.96, 95% CI 1.57–2.45), gangrene (3.4% vs. 2.3%, SHR 1.44, 95% CI 1.10–1.90) and amputation (2.5% vs. 1.7%; SHR 1.42, 95% CI 1.03–1.95) than the 10,085 matched controls without DVT. They also tended to have a greater risk of all-cause mortality (38.1% vs. 33.1%; hazard ratio [HR] 1.18, 95% CI 1.09–1.27) and systemic thromboembolism (4.2% vs. 2.6%; SHR 1.56, 95% CI 1.22–1.99), respectively. We showed the presence of DVT may be associated with an increased risk of MALEs, major amputation, and thromboembolism, contributing to a higher mortality rate in T2DM.Po-Chang WangTien-Hsing ChenChang-Min ChungMei-Yen ChenJung-Jung ChangYu-Sheng LinPao-Hsien ChuYun-Shing PengMing-Shyan LinNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Po-Chang Wang Tien-Hsing Chen Chang-Min Chung Mei-Yen Chen Jung-Jung Chang Yu-Sheng Lin Pao-Hsien Chu Yun-Shing Peng Ming-Shyan Lin The effect of deep vein thrombosis on major adverse limb events in diabetic patients: a nationwide retrospective cohort study
description	Abstract Little is known about the association between deep vein thrombosis (DVT) and arterial complications in patients with type 2 diabetes (T2DM). The aim of this retrospective cohort study was to assess the influence of prior DVT on major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) in T2DM. A total of 1,628,675 patients with T2DM with or without a history of DVT from 2001 to 2013 were identified in the National Health Insurance Research Database of Taiwan. Before matching, the patients in the DVT group (n = 2020) were older than the control group (66.3 vs. 58.3 years). Patients in the DVT group were more likely to be female than the control group (54.3% vs. 47.5%). Before matching, the DVT group had higher prevalence of most comorbidities, more prescription of antiplatelet, antihypertensive agents and insulins, but less prescription of metformin and sulfonylurea. During a mean follow-up of 5.2 years (standard deviation: 3.9 years), the matched DVT group (n = 2017) have a significantly increased risk of MALE (8.4% vs. 5.2%; subdistribution hazard ratio [SHR] 1.60, 95% CI 1.34–1.90), foot ulcer (5.2% vs. 2.6%, SHR 1.96, 95% CI 1.57–2.45), gangrene (3.4% vs. 2.3%, SHR 1.44, 95% CI 1.10–1.90) and amputation (2.5% vs. 1.7%; SHR 1.42, 95% CI 1.03–1.95) than the 10,085 matched controls without DVT. They also tended to have a greater risk of all-cause mortality (38.1% vs. 33.1%; hazard ratio [HR] 1.18, 95% CI 1.09–1.27) and systemic thromboembolism (4.2% vs. 2.6%; SHR 1.56, 95% CI 1.22–1.99), respectively. We showed the presence of DVT may be associated with an increased risk of MALEs, major amputation, and thromboembolism, contributing to a higher mortality rate in T2DM.
format	article
author	Po-Chang Wang Tien-Hsing Chen Chang-Min Chung Mei-Yen Chen Jung-Jung Chang Yu-Sheng Lin Pao-Hsien Chu Yun-Shing Peng Ming-Shyan Lin
author_facet	Po-Chang Wang Tien-Hsing Chen Chang-Min Chung Mei-Yen Chen Jung-Jung Chang Yu-Sheng Lin Pao-Hsien Chu Yun-Shing Peng Ming-Shyan Lin
author_sort	Po-Chang Wang
title	The effect of deep vein thrombosis on major adverse limb events in diabetic patients: a nationwide retrospective cohort study
title_short	The effect of deep vein thrombosis on major adverse limb events in diabetic patients: a nationwide retrospective cohort study
title_full	The effect of deep vein thrombosis on major adverse limb events in diabetic patients: a nationwide retrospective cohort study
title_fullStr	The effect of deep vein thrombosis on major adverse limb events in diabetic patients: a nationwide retrospective cohort study
title_full_unstemmed	The effect of deep vein thrombosis on major adverse limb events in diabetic patients: a nationwide retrospective cohort study
title_sort	effect of deep vein thrombosis on major adverse limb events in diabetic patients: a nationwide retrospective cohort study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/58c42ebd677b4dafaccf56a03803ca8c
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The effect of deep vein thrombosis on major adverse limb events in diabetic patients: a nationwide retrospective cohort study

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