Key result
Type 2 diabetes linked to ~34% higher mortality following a first cardiovascular event.
Why the study?
To quantify ethnic differences in the risk of all-cause mortality and CVD events following a first CVD event in people with and without type 2 diabetes.
Does type 2 diabetes and ethnicity affect the risk of all-cause mortality, cardiovascular mortality, and recurrent cardiovascular events in adults hospitalized with a first cardiovascular disease event in England?
Cohort (n=5,349,271)
Yes
Does type 2 diabetes and ethnicity affect the risk of all-cause mortality, cardiovascular mortality, and recurrent cardiovascular events in adults hospitalized with a first cardiovascular disease event in England?
Answers are grounded in this paper and cite their sources.
In over 5.3 million English patients with a first cardiovascular event, type 2 diabetes consistently worsened the risk of recurrent CVD events and mortality by roughly one-third across all groups, whereas ethnic minority patients experienced their first CVD event at a younger age than White patients but had lower age- and deprivation-adjusted risks of subsequent mortality and recurrent events.
AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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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Remsing et al. (2022) conducted a cohort in First cardiovascular disease event (aortic aneurysm, cerebrovascular accident, heart failure, myocardial infarction, peripheral vascular disease, or other CVD) (n=5,349,271). Type 2 diabetes and ethnic minority background (South Asian, Black, Mixed/Other) vs. No type 2 diabetes and White ethnicity was evaluated on All-cause mortality following a first cardiovascular disease event (evaluated by type 2 diabetes status) (HR 1.34, 95% CI 1.34-1.35). Type 2 diabetes increased all-cause mortality following a first cardiovascular event, while minority ethnic groups had lower adjusted mortality rates than White patients.
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