Ethnicity and prognosis following a cardiovascular event in people with and without type 2 diabetes: Observational analysis in over 5 million subjects in England
To quantify ethnic differences in the risk of all–cause mortality and cardiovascular disease (CVD) events following a first CVD event in people with and without type 2 diabetes. We identified 5,349,271 subjects with a first CVD between 1 January 2002 and 31 May 2020 in England; CVD included aortic a...
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| Published in: | Diabetes research and clinical practice Vol. 189; p. 109967 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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01.07.2022
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| ISSN: | 0168-8227, 1872-8227, 1872-8227 |
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| Abstract | To quantify ethnic differences in the risk of all–cause mortality and cardiovascular disease (CVD) events following a first CVD event in people with and without type 2 diabetes.
We identified 5,349,271 subjects with a first CVD between 1 January 2002 and 31 May 2020 in England; CVD included aortic aneurism, cerebrovascular accident, heart failure, myocardial infarction, peripheral vascular disease, and other cardiovascular diseases. We estimated adjusted hazard ratios (HRs) for type 2 diabetes and ethnicity of three outcomes: fatal and nonfatal second CVD event (different phenotype compared to the first) and all–cause mortality.
Relative to White, HRs indicated lower rates in all ethnicities and for all outcomes in both men (from 0.64 to 0.79 for all–cause death; 0.78–0.79 for CVD–related death; and 0.85–0.98 for a second CVD event) and women (0.69–0.77; 0.77–0.83; 0.83–0.95, respectively). Irrespective of ethnicity and sex, type 2 diabetes increased rates of all outcomes by around a third.
Prognosis following a CVD event was consistently worse in subjects with type 2 diabetes while varied across ethnicities, suggesting the implementation of different strategies for the secondary prevention of CVD in different ethnic groups. |
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| AbstractList | To quantify ethnic differences in the risk of all–cause mortality and cardiovascular disease (CVD) events following a first CVD event in people with and without type 2 diabetes.
We identified 5,349,271 subjects with a first CVD between 1 January 2002 and 31 May 2020 in England; CVD included aortic aneurism, cerebrovascular accident, heart failure, myocardial infarction, peripheral vascular disease, and other cardiovascular diseases. We estimated adjusted hazard ratios (HRs) for type 2 diabetes and ethnicity of three outcomes: fatal and nonfatal second CVD event (different phenotype compared to the first) and all–cause mortality.
Relative to White, HRs indicated lower rates in all ethnicities and for all outcomes in both men (from 0.64 to 0.79 for all–cause death; 0.78–0.79 for CVD–related death; and 0.85–0.98 for a second CVD event) and women (0.69–0.77; 0.77–0.83; 0.83–0.95, respectively). Irrespective of ethnicity and sex, type 2 diabetes increased rates of all outcomes by around a third.
Prognosis following a CVD event was consistently worse in subjects with type 2 diabetes while varied across ethnicities, suggesting the implementation of different strategies for the secondary prevention of CVD in different ethnic groups. To quantify ethnic differences in the risk of all-cause mortality and cardiovascular disease (CVD) events following a first CVD event in people with and without type 2 diabetes.AIMSTo quantify ethnic differences in the risk of all-cause mortality and cardiovascular disease (CVD) events following a first CVD event in people with and without type 2 diabetes.We identified 5,349,271 subjects with a first CVD between 1 January 2002 and 31 May 2020 in England; CVD included aortic aneurism, cerebrovascular accident, heart failure, myocardial infarction, peripheral vascular disease, and other cardiovascular diseases. We estimated adjusted hazard ratios (HRs) for type 2 diabetes and ethnicity of three outcomes: fatal and nonfatal second CVD event (different phenotype compared to the first) and all-cause mortality.METHODSWe identified 5,349,271 subjects with a first CVD between 1 January 2002 and 31 May 2020 in England; CVD included aortic aneurism, cerebrovascular accident, heart failure, myocardial infarction, peripheral vascular disease, and other cardiovascular diseases. We estimated adjusted hazard ratios (HRs) for type 2 diabetes and ethnicity of three outcomes: fatal and nonfatal second CVD event (different phenotype compared to the first) and all-cause mortality.Relative to White, HRs indicated lower rates in all ethnicities and for all outcomes in both men (from 0.64 to 0.79 for all-cause death; 0.78-0.79 for CVD-related death; and 0.85-0.98 for a second CVD event) and women (0.69-0.77; 0.77-0.83; 0.83-0.95, respectively). Irrespective of ethnicity and sex, type 2 diabetes increased rates of all outcomes by around a third.RESULTSRelative to White, HRs indicated lower rates in all ethnicities and for all outcomes in both men (from 0.64 to 0.79 for all-cause death; 0.78-0.79 for CVD-related death; and 0.85-0.98 for a second CVD event) and women (0.69-0.77; 0.77-0.83; 0.83-0.95, respectively). Irrespective of ethnicity and sex, type 2 diabetes increased rates of all outcomes by around a third.Prognosis following a CVD event was consistently worse in subjects with type 2 diabetes while varied across ethnicities, suggesting the implementation of different strategies for the secondary prevention of CVD in different ethnic groups.CONCLUSIONSPrognosis following a CVD event was consistently worse in subjects with type 2 diabetes while varied across ethnicities, suggesting the implementation of different strategies for the secondary prevention of CVD in different ethnic groups. |
| ArticleNumber | 109967 |
| Author | Lilford, Richard Lawson, Claire Zaccardi, Francesco Remsing, Sandra C. Abner, Sophia C. Gillies, Clare Khunti, Kamlesh Razieh, Cameron Yates, Tom Davies, Melanie J. Coles, Briana Reeves, Katharine |
| Author_xml | – sequence: 1 givenname: Sandra C. surname: Remsing fullname: Remsing, Sandra C. organization: Department of Research Development and Innovation, University Hospitals Birmingham NHS Foundation Trust, Institute for Translational Medicine, Birmingham, UK – sequence: 2 givenname: Sophia C. surname: Abner fullname: Abner, Sophia C. organization: Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK – sequence: 3 givenname: Katharine surname: Reeves fullname: Reeves, Katharine organization: Department of Research Development and Innovation, University Hospitals Birmingham NHS Foundation Trust, Institute for Translational Medicine, Birmingham, UK – sequence: 4 givenname: Briana surname: Coles fullname: Coles, Briana organization: Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK – sequence: 5 givenname: Claire surname: Lawson fullname: Lawson, Claire organization: Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK – sequence: 6 givenname: Clare surname: Gillies fullname: Gillies, Clare organization: Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK – sequence: 7 givenname: Cameron surname: Razieh fullname: Razieh, Cameron organization: Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK – sequence: 8 givenname: Tom surname: Yates fullname: Yates, Tom organization: Diabetes Research Centre, University of Leicester, Leicester, UK – sequence: 9 givenname: Melanie J. surname: Davies fullname: Davies, Melanie J. organization: Diabetes Research Centre, University of Leicester, Leicester, UK – sequence: 10 givenname: Richard surname: Lilford fullname: Lilford, Richard organization: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK – sequence: 11 givenname: Kamlesh surname: Khunti fullname: Khunti, Kamlesh organization: Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK – sequence: 12 givenname: Francesco surname: Zaccardi fullname: Zaccardi, Francesco email: frazac@fastwebnet.it organization: Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK |
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| Keywords | Type 2 diabetes Cardiovascular disease Ethnicity Prognosis Recurrent event Mortality |
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| SubjectTerms | Cardiovascular disease Cardiovascular Diseases - etiology Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - epidemiology England - epidemiology Ethnicity Female Humans Mortality Myocardial Infarction Prognosis Recurrent event Risk Factors Type 2 diabetes |
| Title | Ethnicity and prognosis following a cardiovascular event in people with and without type 2 diabetes: Observational analysis in over 5 million subjects in England |
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