Christoph H Saely1, Marc Schindewolf2, Daniela Zanolin3, Christine F Heinzle4, Alexander Vonbank5, Guenther Silbernagel2, Andreas Leiherer3, Heinz Drexel6, Iris Baumgartner2. 1. Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein; Division of Angiology, Swiss Cardiovascular Center, University Hospital Berne, Berne, Switzerland. 2. Division of Angiology, Swiss Cardiovascular Center, University Hospital Berne, Berne, Switzerland. 3. Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein. 4. Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria. 5. Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein. 6. Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein; Division of Angiology, Swiss Cardiovascular Center, University Hospital Berne, Berne, Switzerland; Drexel University College of Medicine, Philadelphia, PA, USA. Electronic address: heinz.drexel@extern.insel.ch.
Abstract
BACKGROUND AND AIMS: The individual and combined effects of type 2 diabetes (T2DM) and peripheral artery disease (PAD) on future cardiovascular events are unknown and are addressed in the present investigation. METHODS: Cardiovascular events were prospectively recorded in 1049 subjects, encompassing 4 groups: 558 with neither PAD nor diabetes, 153 with T2DM but without PAD, 192 with PAD but without T2DM and 146 with the combination of PAD and T2DM. RESULTS: Over a mean follow-up period of 7.2 ± 2.6 years, the cardiovascular event rate was lowest in patients with neither PAD nor T2DM (16.7%). Compared to this group the event rate was not significantly increased in T2DM patients without PAD (22.2%, p = 0.077) but higher in non-diabetic patients with PAD (52.6%; p < 0.001) and further increased in patients with both PAD and T2DM (71.2%; p < 0.001). Nondiabetic PAD patients were at a higher cardiovascular risk than T2DM patients without PAD (p < 0.001). Compared to those with neither PAD nor T2DM, hazard ratios after multivariate adjustment were 1.26 [0.84-1.91]; p = 0.267, 4.17 [2.97-5.85]; p < 0.001, and 7.82 [5.49-11.12]; p < 0.001 for those with T2DM only, for those with PAD only and for those with the combination of PAD plus diabetes, respectively. CONCLUSIONS: PAD is a stronger risk factor for future cardiovascular events than T2DM, but T2DM in PAD patients accelerates atherothrombotic disease and strongly increases the incidence of cardiovascular events.
BACKGROUND AND AIMS: The individual and combined effects of type 2 diabetes (T2DM) and peripheral artery disease (PAD) on future cardiovascular events are unknown and are addressed in the present investigation. METHODS: Cardiovascular events were prospectively recorded in 1049 subjects, encompassing 4 groups: 558 with neither PAD nor diabetes, 153 with T2DM but without PAD, 192 with PAD but without T2DM and 146 with the combination of PAD and T2DM. RESULTS: Over a mean follow-up period of 7.2 ± 2.6 years, the cardiovascular event rate was lowest in patients with neither PAD nor T2DM (16.7%). Compared to this group the event rate was not significantly increased in T2DM patients without PAD (22.2%, p = 0.077) but higher in non-diabeticpatients with PAD (52.6%; p < 0.001) and further increased in patients with both PAD and T2DM (71.2%; p < 0.001). Nondiabetic PADpatients were at a higher cardiovascular risk than T2DM patients without PAD (p < 0.001). Compared to those with neither PAD nor T2DM, hazard ratios after multivariate adjustment were 1.26 [0.84-1.91]; p = 0.267, 4.17 [2.97-5.85]; p < 0.001, and 7.82 [5.49-11.12]; p < 0.001 for those with T2DM only, for those with PAD only and for those with the combination of PAD plus diabetes, respectively. CONCLUSIONS: PAD is a stronger risk factor for future cardiovascular events than T2DM, but T2DM in PAD patients accelerates atherothrombotic disease and strongly increases the incidence of cardiovascular events.
Authors: Christoph H Saely; Marc Schindewolf; Daniela Zanolin; Christine F Heinzle; Alexander Vonbank; Guenther Silbernagel; Andreas Leiherer; Heinz Drexel; Iris Baumgartner Journal: Data Brief Date: 2018-11-03
Authors: Lukas Sprenger; Arthur Mader; Barbara Larcher; Maximilian Mächler; Alexander Vonbank; Daniela Zanolin-Purin; Andreas Leiherer; Axel Muendlein; Heinz Drexel; Christoph H Saely Journal: BMJ Open Diabetes Res Care Date: 2021-11