Cardiorenal disease is commonly the first cardiovascular disease (CVD) manifestation in patients with type 2 diabetes (T2D) without a history of CVD disease, significantly increasing risk for all-cause mortality in this patient population, according to study results presented at the 55th Annual Meeting of the European Association for the Study of Diabetes, held September 16 to 20, 2019, in Barcelona, Spain.
Using healthcare insurance claims registries in Germany and Japan and full population registries from Norway and Sweden, researchers collected data from patients with T2D without a history of CVD or chronic kidney disease (CKD; n=687,732). The study investigators identified any first record of stroke, myocardial infarction, peripheral artery disease, and cardiorenal disease (heart failure [HF] or CKD) in these patients. Risk was compared between a group without CVD and groups that had only HF, only CKD, or both HF and CKD.
During a mean follow-up period of 3.9 years, cardiorenal disease was the most common manifestation (14%; n=99,242) in patients who developed CVD. After cardiorenal disease, the most common CVD manifestations were stroke in Japan and stroke or myocardial infarction in Germany, Norway, and Sweden. Across all countries, cardiorenal events comprised of 46% HF and 54% CKD.
An increased risk for CKD was associated with HF (hazard ratio [HR], 2.71; 95% CI, 1.88-3.92), and the presence of CKD was associated with increased HF risk (HR, 2.14; 95% CI, 1.57-2.91). An increased risk for all-cause mortality was associated with CKD (HR, 1.76; 95% CI, 1.45-2.15), HF (HR, 2.17; 95% CI, 1.78-2.65), and HF plus CKD (HR, 3.08; 95% CI, 2.41-3.94). For cardiovascular-specific mortality, greater risk was associated with CKD (HR, 1.94; 95% CI, 1.77-2.14) and HF (HR, 2.41; 95% CI, 2.23-2.62).
The researchers concluded that their findings “show that cardiorenal disease is an important early complication in T2D, that should be considered when choosing optimal preventive strategies for these patients.”
Disclosure: This clinical trial was supported by AstraZeneca. Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Birkeland K, Bodegard J, Eriksson J, et al. Cardiorenal disease is the most common first CV manifestation in type 2 diabetes and associated with increased mortality: a large multinational observational study. Presented at: European Association for the Study of Diabetes 55th Annual Meeting; September 16-20, 2019; Barcelona, Spain. Abstract 126.