Seferovic, J. P. et al. (2018) Retinopathy, neuropathy, and subsequent cardiovascular events in patients with type 2 diabetes and acute coronary syndrome in the ELIXA: the importance of disease duration. Journal of Diabetes Research, 2018, 1631263. (doi: 10.1155/2018/1631263) (PMID:30648112) (PMCID:PMC6311850)
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Abstract
Introduction: We investigated the association of diabetic retinopathy and neuropathy with increased risk of recurrent cardiovascular (CV) events in 6068 patients with type 2 diabetes mellitus (T2DM) and recent acute coronary syndrome (ACS) enrolled in the Evaluation of Lixisenatide in Acute Coronary Syndrome (ELIXA). Methods: History of retinopathy and neuropathy as well as duration of T2DM were self-reported at screening. Proportional hazards regression models were used to assess relationships between retinopathy, neuropathy, and recurrent CV events. Results: At screening, retinopathy and neuropathy were reported in 10.7% and 17.5% of patients, respectively, while 5.7% reported both. When adjusted for randomized treatment only, both retinopathy and neuropathy were associated with a primary composite outcome (CV death, nonfatal MI, stroke, or hospitalization for unstable angina) (retinopathy: HR 1.44, 95% CI 1.19-1.75; neuropathy: HR 1.33, 95% CI 1.12-1.57), CV composite (CV death, nonfatal MI, stroke, hospitalization for heart failure (HF)) (retinopathy: HR 1.57, 95% CI 1.31-1.88; neuropathy: HR 1.38, 95% CI 1.19-1.62), myocardial infarction (retinopathy: HR 1.38, 95% CI 1.08-1.76; neuropathy: HR 1.26, 95% CI 1.02-1.54), HF hospitalization (retinopathy: HR 2.03, 95% CI 1.48-2.78; neuropathy: HR 1.71, 95% CI 1.30-2.27), and all-cause mortality (retinopathy: HR 1.65, 95% CI 1.28-2.12; neuropathy: HR 1.43, 95% CI 1.14-1.78). When included in the same model, and adjusted for T2DM duration, there were no independent associations of either with CV outcomes, while T2DM duration remained strongly associated with all outcomes. Addition of demographic characteristics and CV risk factors did not further alter these relationships. Conclusions: In patients with T2DM and recent ACS, a history of retinopathy and/or neuropathy and longer T2DM duration could be considered clinical markers for high risk of recurrent CV events.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | McMurray, Professor John |
| Authors: | Seferovic, J. P., Bentley-Lewis, R., Claggett, B., Diaz, R., Gerstein, H. C., Køber, L. V., Lawson, F. C., Lewis, E. F., Maggioni, A. P., McMurray, J. J.V., Probstfield, J. L., Riddle, M. C., Solomon, S. D., Tardif, J.-C., and Pfeffer, M. A. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | Journal of Diabetes Research |
| Publisher: | Hindawi |
| ISSN: | 2314-6745 |
| ISSN (Online): | 2314-6753 |
| Published Online: | 16 December 2018 |
| Copyright Holders: | Copyright © 2018 Jelena P. Seferovic et al. |
| First Published: | First published in Journal of Diabetes Research 2018:1631263 |
| Publisher Policy: | Reproduced under a Creative Commons license |
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