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Cardiovascular events and mortality in people with type 2 diabetes and multimorbidity: a real world study of patients followed up to 19 years

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journal contribution
posted on 2020-10-29, 13:06 authored by Briana Coles, Francesco Zaccardi, Christian Hvid, Melanie J Davies, Kamlesh Khunti
Aim
To quantify the risk of cardiovascular disease (CVD) events, all‐cause mortality and cardiovascular mortality in patients diagnosed with type 2 diabetes (T2D) and multimorbidity.

Methods
This retrospective study used English primary and secondary care data to identify 120 409 adults newly diagnosed with T2D during 2000–2018 with follow‐up until death or 31 December 2018. Patients were classified according to the level and type of multimorbidity at T2D diagnosis, and adjusted hazard ratios (aHRs) were calculated for each outcome.

Results
In total, 66 977 (55.6%) patients had T2D only, 37 894 (31.5%) had one co‐morbidity, 11 357 (9.4%) had two co‐morbidities, 3186 (2.6%) patients had three co‐morbidities and 995 (0.8%) patients had four or more co‐morbidities. Co‐morbidities were associated with increased aHRs for all outcomes. Compared with patients with T2D only, at 19 years after diagnosis of T2D the aHR for four or more co‐morbidities was 2.57 (95% CI 2.45‐2.69) for a CVD event, 1.73 (1.68‐1.78) for all‐cause mortality and 2.68 (2.52–2.85) for cardiovascular mortality. Also, 100 183 (83.2%) patients had no CVD co‐morbidities, 16 874 (14.0%) patients had one CVD co‐morbidity and 3352 (2.8%) patients had two or more co‐morbidities. Compared with patients with no CVD co‐morbidities, at 19 years after diagnosis of T2D the aHR for two or more CVD co‐morbidities was 2.42 (2.35‐2.49) for a CVD event, 1.44 (1.42‐1.47) for all‐cause mortality and 2.44 (2.35‐2.54) for cardiovascular mortality.

Conclusion
In people with T2D, level of multimorbidity and, in particular, CVD multimorbidity increased the risk of subsequent CVD events, mortality and cardiovascular mortality.

Funding

This study was funded by Novo Nordisk Region Europe Pharmaceuticals

History

Citation

Diabetes, Obesity and Metabolism, 2020, https://doi.org/10.1111/dom.14218

Author affiliation

Diabetes Research Centre, College of Life Sciences

Version

  • VoR (Version of Record)

Published in

Diabetes, Obesity and Metabolism

Publisher

Wiley

issn

1462-8902

eissn

1463-1326

Acceptance date

2020-10-04

Copyright date

2020

Available date

2020-10-22

Language

en

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