Key result
Intensive 1-day complication screening in patients with type 2 diabetes significantly reduced the incidence of 4-point MACE by 30% compared to standard staggered screening (HR 0.70).
Why the study?
Complication screening is recommended for patients with T2D, but the optimal screening intensity and schedules remain unknown.
Does intensive complication screening reduce 4p-MACE in patients with type 2 diabetes compared to standard screening?
Observational (n=1,040)
No
Does intensive complication screening reduce 4p-MACE in patients with type 2 diabetes compared to standard screening?
Intensive 1-day complication screening with counseling in type 2 diabetes patients is associated with a lower risk of 4p-MACE, primarily driven by reduced heart failure hospitalizations, compared to standard screening.
Answers are grounded in this paper and cite their sources.
Intensive screening may associate with better CV outcomes in T2D; leaves open whether it improves prognosis over standard care.
BACKGROUND: Complication screening is recommended for patients with type 2 diabetes (T2D), but the optimal screening intensity and schedules are unknown. In this study, we evaluated whether intensive versus standard complication screening affects long-term cardiovascular outcomes. METHODS: In this observational study, we included 368 T2D patients referred for intensive screening provided as a 1-day session of clinical-instrumental evaluation of diabetic complications, followed by dedicated counseling. From a total of 4906 patients, we selected control T2D patients who underwent standard complication screening at different visits, by 2:1 propensity score matching. The primary endpoint was the 4p-MACE, defined as cardiovascular mortality, or non-fatal myocardial infarction, stroke, or heart failure. The Cox proportional regression analyses was used to compare outcome occurrence in the two groups, adjusted for residual confounders. RESULTS: 357 patients from the intensive screening group (out of 368) were matched with 683 patients in the standard screening group. Clinical characteristics were well balanced between the two groups, except for a slightly higher prevalence of microangiopathy in the intensive group (56% vs 50%; standardized mean difference 0.11, p = 0.1). Median follow-up was 5.6 years. The adjusted incidence of 4p-MACE was significantly lower in the intensive versus standard screening group (HR 0.70; 95% CI 0.52-0.95; p = 0.02). All components of the primary endpoint had nominally lower rates in the intensive versus standard screening group, which was particularly significant for heart failure (HR 0.43; 95% CI 0.22-0.83; p = 0.01). CONCLUSION: Among T2D patients attending a specialist outpatient clinic, intensive complication screening is followed by better long-term cardiovascular outcomes. No significant effect was noted for cardiovascular and all-cause mortality and the benefit was mainly driven by a reduced rate of hospitalization for heart failure.
No takes yet. Share an insight, caveat, or question.
Morieri et al. (2019) conducted an observational in Type 2 diabetes (n=1,040). Intensive complication screening (1-day session) vs. Standard complication screening (staggered visits) was evaluated on 4-point MACE (cardiovascular mortality, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure) (HR 0.70, 95% CI 0.52-0.95, p=0.022). Intensive 1-day complication screening in patients with type 2 diabetes significantly reduced the incidence of 4-point MACE by 30% compared to standard staggered screening (HR 0.70).
Synapse has enriched 10 related papers. Consider them for comparative context: