Abstract
Aims: To quantify ethnic differences in the risk of all–cause mortality and cardiovascular disease (CVD) events following a first CVD event in people with and without type 2 diabetes.
Methods: We identified 5,349,271 subjects with a first CVD between 1 January 2002 and 31 May 2020 in England; CVD included aortic aneurism, cerebrovascular accident, heart failure, myocardial infarction, peripheral vascular disease, and other cardiovascular diseases. We estimated adjusted hazard ratios (HRs) for type 2 diabetes and ethnicity of three outcomes: fatal and nonfatal second CVD event (different phenotype compared to the first) and all–cause mortality.
Results: Relative to White, HRs indicated lower rates in all ethnicities and for all outcomes in both men (from 0.64 to 0.79 for all–cause death; 0.78–0.79 for CVD–related death; and 0.85–0.98 for a second CVD event) and women (0.69–0.77; 0.77–0.83; 0.83–0.95, respectively). Irrespective of ethnicity and sex, type 2 diabetes increased rates of all outcomes by around a third.
Conclusions: Prognosis following a CVD event was consistently worse in subjects with type 2 diabetes while varied across ethnicities, suggesting the implementation of different strategies for the secondary prevention of CVD in different ethnic groups.
Methods: We identified 5,349,271 subjects with a first CVD between 1 January 2002 and 31 May 2020 in England; CVD included aortic aneurism, cerebrovascular accident, heart failure, myocardial infarction, peripheral vascular disease, and other cardiovascular diseases. We estimated adjusted hazard ratios (HRs) for type 2 diabetes and ethnicity of three outcomes: fatal and nonfatal second CVD event (different phenotype compared to the first) and all–cause mortality.
Results: Relative to White, HRs indicated lower rates in all ethnicities and for all outcomes in both men (from 0.64 to 0.79 for all–cause death; 0.78–0.79 for CVD–related death; and 0.85–0.98 for a second CVD event) and women (0.69–0.77; 0.77–0.83; 0.83–0.95, respectively). Irrespective of ethnicity and sex, type 2 diabetes increased rates of all outcomes by around a third.
Conclusions: Prognosis following a CVD event was consistently worse in subjects with type 2 diabetes while varied across ethnicities, suggesting the implementation of different strategies for the secondary prevention of CVD in different ethnic groups.
Original language | English |
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Article number | 109967 |
Number of pages | 9 |
Journal | Diabetes Research and Clinical Practice |
Volume | 189 |
Early online date | 16 Jun 2022 |
DOIs | |
Publication status | Published - Jul 2022 |
Keywords
- Cardiovascular disease
- Ethnicity
- Mortality
- Prognosis
- Recurrent event
- Type 2 diabetes