PMID- 28587650
OWN - NLM
STAT- MEDLINE
DCOM- 20180226
LR  - 20220331
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 16
IP  - 1
DP  - 2017 Jun 6
TI  - Impact of diabetes duration and degree of carotid artery stenosis on major 
      adverse cardiovascular events: a single-center, retrospective, observational 
      cohort study.
PG  - 74
LID - 10.1186/s12933-017-0556-0 [doi]
LID - 74
AB  - BACKGROUND: We aimed to investigate the impact of diabetes duration and carotid 
      artery stenosis (CAS) on the occurrence of major adverse cardiovascular events 
      (MACE) in patients with type 2 diabetes mellitus (T2DM) without clinical 
      cardiovascular disease. METHODS: A total of 2006 patients with T2DM, without 
      clinical cardiovascular disease, aged >50 years, and who underwent baseline 
      carotid Doppler ultrasound screening with regular follow-ups at the outpatient 
      clinic of our diabetes center, were stratified into four subgroups according to 
      diabetes duration and CAS degree. The primary outcomes included the occurrence of 
      MACE, defined as fatal or nonfatal stroke and myocardial infarction, and 
      all-cause mortality. RESULTS: The difference in the MACE incidence was 
      significantly greater in patients with a longer diabetes duration (>/=10 years) and 
      significant CAS (50-69% luminal narrowing) (p < 0.001). Analysis of individual 
      MACE components indicated a trend towards an increased incidence of stroke 
      (p < 0.001), parallel to a longer diabetes duration and significant CAS. In 
      contrast, the risk of myocardial infarction was significantly higher in patients 
      with a diabetes duration <10 years and significant CAS (p = 0.039). Multivariate 
      regression analysis showed that patients with both a longer diabetes duration and 
      significant CAS demonstrated additive and very high risks of MACE (hazard ratio 
      [HR], 2.07; 95% confidence interval [CI] 1.17-3.66; p = 0.012) and stroke (HR, 
      3.38; 95% CI 1.54-7.44; p = 0.002). CONCLUSIONS: The risk of MACE is 
      significantly greater in patients with T2DM, without clinical cardiovascular 
      disease, who have both a longer diabetes duration and significant CAS, compared 
      with those who have a shorter duration and/or nonsignificant CAS.
FAU - Noh, Minsu
AU  - Noh M
AD  - Department of Surgery, University of Ulsan College of Medicine and Asan Medical 
      Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 05505, South Korea.
FAU - Kwon, Hyunwook
AU  - Kwon H
AD  - Department of Surgery, University of Ulsan College of Medicine and Asan Medical 
      Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 05505, South Korea.
FAU - Jung, Chang Hee
AU  - Jung CH
AD  - Department of Internal Medicine, University of Ulsan College of Medicine and Asan 
      Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 05505, South Korea.
FAU - Kwon, Sun U
AU  - Kwon SU
AD  - Department of Neurology, University of Ulsan College of Medicine and Asan Medical 
      Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 05505, South Korea.
FAU - Kim, Min Seon
AU  - Kim MS
AD  - Department of Internal Medicine, University of Ulsan College of Medicine and Asan 
      Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 05505, South Korea.
FAU - Lee, Woo Je
AU  - Lee WJ
AD  - Department of Internal Medicine, University of Ulsan College of Medicine and Asan 
      Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 05505, South Korea.
FAU - Park, Joong Yeol
AU  - Park JY
AD  - Department of Internal Medicine, University of Ulsan College of Medicine and Asan 
      Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 05505, South Korea.
FAU - Han, Youngjin
AU  - Han Y
AD  - Department of Surgery, University of Ulsan College of Medicine and Asan Medical 
      Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 05505, South Korea.
FAU - Kim, Hyangkyoung
AU  - Kim H
AD  - Department of Surgery, Chung-Ang University Hospital, 102 Heukseok-ro, 
      Dongjak-gu, Seoul, 06973, South Korea.
FAU - Kwon, Tae-Won
AU  - Kwon TW
AD  - Department of Surgery, University of Ulsan College of Medicine and Asan Medical 
      Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 05505, South Korea.
FAU - Cho, Yong-Pil
AU  - Cho YP
AUID- ORCID: 0000-0002-0639-451X
AD  - Department of Surgery, University of Ulsan College of Medicine and Asan Medical 
      Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 05505, South Korea. 
      ypcho@amc.seoul.kr.
LA  - eng
PT  - Journal Article
DEP - 20170606
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
SB  - IM
MH  - Aged
MH  - Carotid Stenosis/diagnostic imaging/*epidemiology/mortality
MH  - Chi-Square Distribution
MH  - Diabetes Mellitus, Type 2/diagnosis/*epidemiology/mortality
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/diagnosis/*epidemiology/mortality
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Republic of Korea/epidemiology
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Stroke/diagnosis/*epidemiology/mortality
MH  - Time Factors
MH  - Ultrasonography, Doppler
PMC - PMC5461631
OTO - NOTNLM
OT  - Cardiovascular diseases
OT  - Carotid artery stenosis
OT  - Diabetes mellitus
EDAT- 2017/06/08 06:00
MHDA- 2018/02/27 06:00
PMCR- 2017/06/06
CRDT- 2017/06/08 06:00
PHST- 2017/04/26 00:00 [received]
PHST- 2017/05/29 00:00 [accepted]
PHST- 2017/06/08 06:00 [entrez]
PHST- 2017/06/08 06:00 [pubmed]
PHST- 2018/02/27 06:00 [medline]
PHST- 2017/06/06 00:00 [pmc-release]
AID - 10.1186/s12933-017-0556-0 [pii]
AID - 556 [pii]
AID - 10.1186/s12933-017-0556-0 [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2017 Jun 6;16(1):74. doi: 10.1186/s12933-017-0556-0.