Prevalence of diabetic and impact on cardiovascular events and mortality in patients with chronic coronary syndromes, across multiple geographical regions and ethnicities
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Background: In contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity. Methods: CLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia and Africa in 2009-2010, and followed-up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischemia, or prior revascularisation procedure. Results: Among 32,694patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to approximately 60% in the Gulf countries. In a multivariable-adjusted Cox proportional hazards model, diabetes was associated with increased risks for the primary outcome(cardiovascular death, myocardial infarction or stroke)with an adjusted hazard ratio of1.28(95% CI 1.18-1.39) and for all secondary outcomes (all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure and coronary revascularization). Differences on outcomes according to geography and ethnicity were modest. Conclusion: In patients with chronic coronary syndromes, diabetes is independently associated with mortality and cardiovascular events, including heart failure, which is not accounted by demographics, prior medical history, left ventricular ejection fraction, or use of secondary prevention medication. This is observed across multiple geographic regions and ethnicities, despite marked disparities in the prevalence of diabetes.
Date Issued
2021-12-01
Date Acceptance
2021-01-11
Citation
European Journal of Preventive Cardiology, 2021, 28 (16), pp.1795-1806
ISSN
2047-4873
Publisher
SAGE Publications
Start Page
1795
End Page
1806
Journal / Book Title
European Journal of Preventive Cardiology
Volume
28
Issue
16
Copyright Statement
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. This is a pre-copy-editing, author-produced version of an article accepted for publication in [insert journal title] following peer review. The definitive publisher-authenticated version is available online at: https://academic.oup.com/eurjpc/article/28/16/1795/6211611
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
CLARIFY registry
Diabetes
Chronic coronary syndromes
Geographical disparities
ARTERY-DISEASE
MYOCARDIAL-INFARCTION
LONG-TERM
EUROPEAN-SOCIETY
HEART-FAILURE
MIDDLE-EAST
RISK
GLUCOSE
MELLITUS
OUTCOMES
CLARIFY registry
Chronic coronary syndromes
Diabetes
Geographical disparities
CLARIFY Investigators
Publication Status
Published
Date Publish Online
2021-04-06