Abstract Aims To utilise Fremantle Diabetes Study Phase II (FDS2) data to examine the association between Type 2 diabetes and incident aortic valve replacement (AVR) and to investigate potential risk factors in Type 2 diabetes. Methods We followed 1430 FDS2 participants (mean age 66 years, 53% males) and 5720 age‐, sex‐, and postcode‐matched people without diabetes from entry (2008–2011) to end‐2021 for AVR ascertained from validated linked databases. Incidence rate ratios (IRRs) were calculated. Cox proportional hazards and competing risk models generated cause‐specific (cs) and subdistribution (sd) hazard ratios (HRs) for incident AVR. Results At baseline, 11 participants with Type 2 diabetes (0.8%) and 37 without diabetes (0.6%) had undergone AVR ( p = 0.589). There were 24 (1.7%) and 40 (0.7%) first incident AVR hospitalisations, respectively, in the two groups during 73,498 person‐years of follow‐up (IRR 2.40 95% confidence interval (CI) 1.38, 4.08, p = 0.0007). In pooled analyses, Type 2 diabetes had similar csHR (2.38 1.43, 3.96) and sdHR (2.34 1.41, 3.88), with increasing age and male sex as other statistically significant covariates. In Type 2 diabetes, incident AVR was bivariably associated with baseline blood glucose‐lowering treatment intensity ( p = 0.003) and with distal symmetrical polyneuropathy (DSPN) after age and sex adjustment ( p = 0.025). Conclusions Type 2 diabetes more than doubles the risk of AVR after adjusting for the competing risk of death. People with Type 2 diabetes going on to require AVR were more intensively managed and were more likely to have DSPN at baseline.
Davis et al. (Mon,) studied this question.
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