D Aune1, S Schlesinger2, T Norat3, E Riboli3. 1. Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom; Bjørknes University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway. Electronic address: d.aune@imperial.ac.uk. 2. Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Germany. 3. Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom.
Abstract
BACKGROUND: Although diabetes mellitus is an established risk factor for myocardial infarction and stroke, data on the association with sudden cardiac death are less extensive and the findings have not been entirely consistent. We therefore conducted a systematic review and meta-analysis of prospective studies on diabetes mellitus and risk of sudden cardiac death. METHODS AND RESULTS: PubMed and Embase databases were searched up to July 18th 2017. Prospective studies that reported adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for the association between a diabetes diagnosis or pre-diabetes and risk of sudden cardiac death were included. Summary RRs were estimated by use of a random effects model. Nineteen population-based prospective studies (11 publications) (3610 cases, 249,225 participants) and 10 patient-based prospective studies (2713 cases, 55,098 participants) were included. The summary RR for diabetes patients vs. persons without diabetes was 2.02 (95% CI: 1.81-2.25, I2 = 0%, pheterogeneity = 0.91) in the population-based studies. The summary RR was 1.23 (95% CI: 1.05-1.44, I2 = 6%, pheterogeneity = 0.34) for the association between pre-diabetes and sudden cardiac death (n = 3 studies, 1000 sudden cardiac deaths, 18,360 participants). In the patient-based studies, the summary RR of sudden cardiac death for diabetes patients vs. patients without diabetes was 1.75 (95% CI: 1.51-2.03, I2 = 39%, pheterogeneity = 0.10) for all patients combined, 1.63 (95% CI: 1.36-1.97, I2 = 39%, n = 5) for coronary heart disease patients, and 1.85 (95% CI: 1.48-2.33, I2 = 0%, n = 3) for heart failure patients. CONCLUSIONS: These results suggest that diabetes patients are at an increased risk of sudden cardiac death both in the general population and among different patient groups.
BACKGROUND: Although diabetes mellitus is an established risk factor for myocardial infarction and stroke, data on the association with sudden cardiac death are less extensive and the findings have not been entirely consistent. We therefore conducted a systematic review and meta-analysis of prospective studies on diabetes mellitus and risk of sudden cardiac death. METHODS AND RESULTS: PubMed and Embase databases were searched up to July 18th 2017. Prospective studies that reported adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for the association between a diabetes diagnosis or pre-diabetes and risk of sudden cardiac death were included. Summary RRs were estimated by use of a random effects model. Nineteen population-based prospective studies (11 publications) (3610 cases, 249,225 participants) and 10 patient-based prospective studies (2713 cases, 55,098 participants) were included. The summary RR for diabetespatients vs. persons without diabetes was 2.02 (95% CI: 1.81-2.25, I2 = 0%, pheterogeneity = 0.91) in the population-based studies. The summary RR was 1.23 (95% CI: 1.05-1.44, I2 = 6%, pheterogeneity = 0.34) for the association between pre-diabetes and sudden cardiac death (n = 3 studies, 1000 sudden cardiac deaths, 18,360 participants). In the patient-based studies, the summary RR of sudden cardiac death for diabetespatients vs. patients without diabetes was 1.75 (95% CI: 1.51-2.03, I2 = 39%, pheterogeneity = 0.10) for all patients combined, 1.63 (95% CI: 1.36-1.97, I2 = 39%, n = 5) for coronary heart diseasepatients, and 1.85 (95% CI: 1.48-2.33, I2 = 0%, n = 3) for heart failurepatients. CONCLUSIONS: These results suggest that diabetespatients are at an increased risk of sudden cardiac death both in the general population and among different patient groups.
Authors: Ghadeer K Dawwas; Sean Hennessy; Colleen M Brensinger; Rajat Deo; Warren B Bilker; Samantha E Soprano; Neil Dhopeshwarkar; James H Flory; Zachary T Bloomgarden; Christina L Aquilante; Stephen E Kimmel; Charles E Leonard Journal: Clin Pharmacol Ther Date: 2021-08-17 Impact factor: 6.903