Reduced Long‐Term Risk of Aortic Aneurysm and Aortic Dissection Among Individuals With Type 2 Diabetes Mellitus: A Nationwide Observational Study

Journal of the American Heart Association - Tập 7 Số 3 - 2018
Tarik Avdic1, Stefan Franzén2, Moncef Zarrouk3, Stefan Acosta3, Peter M. Nilsson4, Anders Gottsäter3, Ann‐Marie Svensson2, Soffia Guðbjörnsdóttir5,2, Björn Eliasson5,2
1Tarik Avdic Swedish National Diabetes Register, Center of Registers in Region, Gothenburg, Sweden
2Swedish National Diabetes Register, Center of Registers in Region, Gothenburg, Sweden
3Department of Clinical Sciences, Vascular Center, Skåne University Hospital, Lund University, Malmö, Sweden
4Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
5Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sweden

Tóm tắt

Background No studies have examined long‐term risks for aortic aneurysm ( AA ) and aortic dissection ( AD ) or mortality after AA or AD hospitalization among patients with type 2 diabetes mellitus (T2 DM ).

Methods and Results In this observational cohort study, we linked data for patients with T2 DM in the Swedish National Diabetes Register, and 5 individually matched population‐based control subjects ( CSs ) without diabetes mellitus (on the basis of sex, age, and county), to other national databases to capture hospitalizations and death. We examined the risk of hospitalization for AA and AD , as well as mortality risk after AA and AD using Kaplan‐Meier curves and Cox regression hazards models. Data on 448 319 patients with T2DM and 2 251 015 CSs were obtained between 1998 and 2015. Mean follow‐up time was 7.0 years for the T2 DM group and 7.2 years for the CS group. Patients with T2 DM had a relative risk reduction of 28% (hazard ratio, 0.72; 95% confidence interval, 0.68–0.76; P <0.0001) for AA and a 47% relative risk reduction (hazard ratio, 0.53; 95% confidence interval, 0.42–0.65; P <0.0001) for AD compared with CSs . Patients with T2DM had a relative risk reduction of 12% (hazard ratio, 0.88; 95% confidence interval, 0.82–0.94; P <0.0001) for mortality after hospitalization for AA , and unaltered risk (hazard ratio, 1.07; 95% confidence interval, 0.85–1.34; P =0.5859) for mortality after AD , up to 2 years compared with CSs .

Conclusions Patients with T2DM had significantly reduced risks of AA and AD as well as reduced risk of mortality after hospitalization for AA, compared to CS . Data suggest that glycated cross‐links in aortic tissue may play a protective role in the progression of aortic diseases among patients with T2DM.

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Journal of the American Heart Association

Tập 7 Số 3

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