Contribution of type 2 diabetes to major adverse cardiovascular events (MACE) in a long-term observational study with different stages of atherosclerosis
Abstract The impact of diabetes on incident cardiovascular disease in relation to the extent of atherosclerotic disease remains unclear. We aimed to investigate major adverse cardiovascular events (MACE) in patients with or without type 2 diabetes (T2DM) presenting with two extremes of atherosclerot...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-01-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-024-84985-x |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832585789590994944 |
|---|---|
| author | Arthur Mader Dario Haeberli Barbara Larcher Jörn F. Dopheide Christoph H. Saely Christine F. Heinzle Peter Amann Marc Schindewolf Andreas Festa Heinz Drexel |
| author_facet | Arthur Mader Dario Haeberli Barbara Larcher Jörn F. Dopheide Christoph H. Saely Christine F. Heinzle Peter Amann Marc Schindewolf Andreas Festa Heinz Drexel |
| author_sort | Arthur Mader |
| collection | DOAJ |
| description | Abstract The impact of diabetes on incident cardiovascular disease in relation to the extent of atherosclerotic disease remains unclear. We aimed to investigate major adverse cardiovascular events (MACE) in patients with or without type 2 diabetes (T2DM) presenting with two extremes of atherosclerotic disease, those with angiographically documented minor coronary atherosclerotic lesions and those with symptomatic peripheral artery disease. We included 1238 patients from two prospective, long-term cohort studies. Patients underwent coronary angiography and/or sonography in order to assess the grade of atherosclerosis and were defined as having no signs of Atherosclerosis (n = 332; Group I), minor atherosclerosis (n = 425; Group II) and major atherosclerosis (n = 481; Group III). Cardiovascular events were recorded over a median follow-up period of 7.1 years (Q1 = 3.6 years, Q2 = 7.1 years, Q3 = 11.3 years), covering a total of 9533 patient years. We tested the hypothesis that T2DM infers the same relative risk increase irrespective of the atherosclerosis stage, considering 3-point MACE as the primary endpoint. Incident MACE was reported in 681 patients (51%). MACE occurred more frequently in patients with T2DM than in patients without T2DM (p < 0.001). Further, MACE occurred more frequently in group III (58.1%), than group II (34.1%) or group I (19.1%) (group I vs. group II vs. group III, p < 0.001). In a cox-regression-model, T2DM was a significant predictor of MACE in univariate analyses (HR = 2.43 [1.88–3.14], p < 0.001) and after multivariate adjustment for cardiovascular risk factors, as well as the different grades of atherosclerosis (HR = 1.37 [1.02–1.84], p = 0.034). Also, atherosclerosis grades predicted MACE (HR = 3.19 [2.75–3.70], p < 0.001) in univariate analyses, and also after multivariate adjustment for known cardiovascular risk factors, including T2DM (HR = 1.61 [1.31–1.98], p < 0.001). Finally, when testing for interactions between T2DM and stages of atherosclerosis on MACE we could not find any significant interaction (HR = 1.14 [0.86–1.52], p = 0.364). We conclude that T2DM infers an increased risk for MACE across anatomically and morphologically distinct stages of atherosclerosis. |
| format | Article |
| id | doaj-art-90d6c23940834e3bb1bc06c4160dc3fb |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-90d6c23940834e3bb1bc06c4160dc3fb2025-01-26T12:32:23ZengNature PortfolioScientific Reports2045-23222025-01-011511910.1038/s41598-024-84985-xContribution of type 2 diabetes to major adverse cardiovascular events (MACE) in a long-term observational study with different stages of atherosclerosisArthur Mader0Dario Haeberli1Barbara Larcher2Jörn F. Dopheide3Christoph H. Saely4Christine F. Heinzle5Peter Amann6Marc Schindewolf7Andreas Festa8Heinz Drexel9VIVIT-Institute, Academic Teaching Hospital FeldkirchGefäßzentrum BernVIVIT-Institute, Academic Teaching Hospital FeldkirchVIVIT-Institute, Academic Teaching Hospital FeldkirchVIVIT-Institute, Academic Teaching Hospital FeldkirchVIVIT-Institute, Academic Teaching Hospital FeldkirchVIVIT-Institute, Academic Teaching Hospital FeldkirchAngiology, Inselspital BernVIVIT-Institute, Academic Teaching Hospital FeldkirchVIVIT-Institute, Academic Teaching Hospital FeldkirchAbstract The impact of diabetes on incident cardiovascular disease in relation to the extent of atherosclerotic disease remains unclear. We aimed to investigate major adverse cardiovascular events (MACE) in patients with or without type 2 diabetes (T2DM) presenting with two extremes of atherosclerotic disease, those with angiographically documented minor coronary atherosclerotic lesions and those with symptomatic peripheral artery disease. We included 1238 patients from two prospective, long-term cohort studies. Patients underwent coronary angiography and/or sonography in order to assess the grade of atherosclerosis and were defined as having no signs of Atherosclerosis (n = 332; Group I), minor atherosclerosis (n = 425; Group II) and major atherosclerosis (n = 481; Group III). Cardiovascular events were recorded over a median follow-up period of 7.1 years (Q1 = 3.6 years, Q2 = 7.1 years, Q3 = 11.3 years), covering a total of 9533 patient years. We tested the hypothesis that T2DM infers the same relative risk increase irrespective of the atherosclerosis stage, considering 3-point MACE as the primary endpoint. Incident MACE was reported in 681 patients (51%). MACE occurred more frequently in patients with T2DM than in patients without T2DM (p < 0.001). Further, MACE occurred more frequently in group III (58.1%), than group II (34.1%) or group I (19.1%) (group I vs. group II vs. group III, p < 0.001). In a cox-regression-model, T2DM was a significant predictor of MACE in univariate analyses (HR = 2.43 [1.88–3.14], p < 0.001) and after multivariate adjustment for cardiovascular risk factors, as well as the different grades of atherosclerosis (HR = 1.37 [1.02–1.84], p = 0.034). Also, atherosclerosis grades predicted MACE (HR = 3.19 [2.75–3.70], p < 0.001) in univariate analyses, and also after multivariate adjustment for known cardiovascular risk factors, including T2DM (HR = 1.61 [1.31–1.98], p < 0.001). Finally, when testing for interactions between T2DM and stages of atherosclerosis on MACE we could not find any significant interaction (HR = 1.14 [0.86–1.52], p = 0.364). We conclude that T2DM infers an increased risk for MACE across anatomically and morphologically distinct stages of atherosclerosis.https://doi.org/10.1038/s41598-024-84985-xDiabetes mellitus type 2ImagingProspective studyMajor adverse cardiovascular eventsLower extremity artery diseaseCoronary heart disease |
| spellingShingle | Arthur Mader Dario Haeberli Barbara Larcher Jörn F. Dopheide Christoph H. Saely Christine F. Heinzle Peter Amann Marc Schindewolf Andreas Festa Heinz Drexel Contribution of type 2 diabetes to major adverse cardiovascular events (MACE) in a long-term observational study with different stages of atherosclerosis Scientific Reports Diabetes mellitus type 2 Imaging Prospective study Major adverse cardiovascular events Lower extremity artery disease Coronary heart disease |
| title | Contribution of type 2 diabetes to major adverse cardiovascular events (MACE) in a long-term observational study with different stages of atherosclerosis |
| title_full | Contribution of type 2 diabetes to major adverse cardiovascular events (MACE) in a long-term observational study with different stages of atherosclerosis |
| title_fullStr | Contribution of type 2 diabetes to major adverse cardiovascular events (MACE) in a long-term observational study with different stages of atherosclerosis |
| title_full_unstemmed | Contribution of type 2 diabetes to major adverse cardiovascular events (MACE) in a long-term observational study with different stages of atherosclerosis |
| title_short | Contribution of type 2 diabetes to major adverse cardiovascular events (MACE) in a long-term observational study with different stages of atherosclerosis |
| title_sort | contribution of type 2 diabetes to major adverse cardiovascular events mace in a long term observational study with different stages of atherosclerosis |
| topic | Diabetes mellitus type 2 Imaging Prospective study Major adverse cardiovascular events Lower extremity artery disease Coronary heart disease |
| url | https://doi.org/10.1038/s41598-024-84985-x |
| work_keys_str_mv | AT arthurmader contributionoftype2diabetestomajoradversecardiovasculareventsmaceinalongtermobservationalstudywithdifferentstagesofatherosclerosis AT dariohaeberli contributionoftype2diabetestomajoradversecardiovasculareventsmaceinalongtermobservationalstudywithdifferentstagesofatherosclerosis AT barbaralarcher contributionoftype2diabetestomajoradversecardiovasculareventsmaceinalongtermobservationalstudywithdifferentstagesofatherosclerosis AT jornfdopheide contributionoftype2diabetestomajoradversecardiovasculareventsmaceinalongtermobservationalstudywithdifferentstagesofatherosclerosis AT christophhsaely contributionoftype2diabetestomajoradversecardiovasculareventsmaceinalongtermobservationalstudywithdifferentstagesofatherosclerosis AT christinefheinzle contributionoftype2diabetestomajoradversecardiovasculareventsmaceinalongtermobservationalstudywithdifferentstagesofatherosclerosis AT peteramann contributionoftype2diabetestomajoradversecardiovasculareventsmaceinalongtermobservationalstudywithdifferentstagesofatherosclerosis AT marcschindewolf contributionoftype2diabetestomajoradversecardiovasculareventsmaceinalongtermobservationalstudywithdifferentstagesofatherosclerosis AT andreasfesta contributionoftype2diabetestomajoradversecardiovasculareventsmaceinalongtermobservationalstudywithdifferentstagesofatherosclerosis AT heinzdrexel contributionoftype2diabetestomajoradversecardiovasculareventsmaceinalongtermobservationalstudywithdifferentstagesofatherosclerosis |