PMID- 34565341 OWN - NLM STAT- MEDLINE DCOM- 20220117 LR - 20220117 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 21 IP - 1 DP - 2021 Sep 26 TI - The effect of preventative cardiovascular therapies on coronary artery disease in people with and without type 2 diabetes: a propensity-matched score study. PG - 463 LID - 10.1186/s12872-021-02265-2 [doi] LID - 463 AB - BACKGROUND: Although it is known that patients with Type 2 Diabetes Mellitus (T2DM) are at an increased risk of coronary artery disease (CAD), the actual coronary artery burden of atherosclerotic disease in patients with and without T2DM in a real-world setting and its possible modification by preventative therapies has not been extensively documented. METHODS: Merged coronary angiography and hospital discharge data between 2013 and 2019 were obtained for analysis and a random sub-sample of patient charts were reviewed for medication use. Propensity scores were estimated using logistic regression models and used to match patients, looking at the effect of severity of CAD over time in years in an ordinal logistic regression model. A separate propensity score was estimated and used to inverse probability weight the ordinal logistic regression looking at the effect of medication use on CAD severity in patients with and without T2DM. RESULTS: From 3,016 patients in the coronary angiography database, 1421 with T2DM and 1421 without T2DM were matched on propensity score. T2DM patients had more extensive CAD in 2018 compared to 2013 ((adjusted odds ratio) adjOR: 2.06 95% C.I. 1.38, 2.07), but this risk appeared to be attenuated in 2019. In contrast, there was no effect of time on CAD burden in patients without diabetes. In the sub-sample of 760 patients who underwent a chart review of their medication use, there were 367 (48%) with T2DM. For patients with T2DM 69.8% reported taking statins, 64.0% RAS inhibitors and 64.0% anti-platelet drugs. This was significantly higher than patients without diabetes of whom 46.6% reported taking statins, 49.0% RAS inhibitors and 49.9% anti-platelet drugs. As in the full matched sample, patients with diabetes had more extensive CAD (adjOR: 1.32 95% CI: 1.01, 1.74). However, after adjustment for the use of RAS inhibitors, statins and anticoagulants there was no difference in extent of CAD between patients with and without diabetes (adjOR: 1.14 95% CI: 0.85, 1.53). CONCLUSIONS: Although patients with diabetes have a greater extent of CAD in comparison to those without T2DM, preventative medication use decreases this CAD burden significantly. CI - (c) 2021. The Author(s). FAU - Kiburg, Katerina V AU - Kiburg KV AUID- ORCID: 0000-0002-3894-5793 AD - Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia. katerina.kiburg@svha.org.au. AD - Department of Medicine, University of Melbourne, Fitzroy, VIC, Australia. katerina.kiburg@svha.org.au. AD - St Vincent's Institute of Medical Research, Fitzroy, VIC, Australia. katerina.kiburg@svha.org.au. FAU - MacIsaac, Andrew I AU - MacIsaac AI AD - Department of Medicine, University of Melbourne, Fitzroy, VIC, Australia. AD - Department of Cardiology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia. FAU - McCluskey, Georgia E AU - McCluskey GE AD - Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia. FAU - Sundararajan, Vijaya AU - Sundararajan V AD - Department of Public Health, La Trobe University, Bundoora, Australia. FAU - MacIsaac, Richard J AU - MacIsaac RJ AD - Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia. AD - Department of Medicine, University of Melbourne, Fitzroy, VIC, Australia. AD - St Vincent's Institute of Medical Research, Fitzroy, VIC, Australia. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20210926 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 RN - 0 (Angiotensin Receptor Antagonists) RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - 0 (Anticoagulants) RN - 0 (Cardiovascular Agents) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Hypoglycemic Agents) RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Aged MH - Angiotensin Receptor Antagonists/therapeutic use MH - Angiotensin-Converting Enzyme Inhibitors/therapeutic use MH - Anticoagulants/therapeutic use MH - Cardiovascular Agents/adverse effects/*therapeutic use MH - Coronary Angiography MH - Coronary Artery Disease/diagnostic imaging/epidemiology/*prevention & control MH - Databases, Factual MH - Diabetes Mellitus, Type 2/diagnosis/*drug therapy/epidemiology MH - Drug Utilization MH - Female MH - Heart Disease Risk Factors MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use MH - Hypoglycemic Agents/adverse effects/*therapeutic use MH - Male MH - Middle Aged MH - Patient Discharge MH - Platelet Aggregation Inhibitors/therapeutic use MH - *Preventive Health Services MH - Prognosis MH - Propensity Score MH - Risk Assessment MH - Time Factors MH - Victoria/epidemiology PMC - PMC8474817 OTO - NOTNLM OT - Coronary angiogram OT - Coronary artery disease OT - Epidemiology OT - Type 2 diabetes COIS- The authors declare that they have no competing interests. EDAT- 2021/09/28 06:00 MHDA- 2022/01/18 06:00 PMCR- 2021/09/26 CRDT- 2021/09/27 05:30 PHST- 2021/01/05 00:00 [received] PHST- 2021/09/14 00:00 [accepted] PHST- 2021/09/27 05:30 [entrez] PHST- 2021/09/28 06:00 [pubmed] PHST- 2022/01/18 06:00 [medline] PHST- 2021/09/26 00:00 [pmc-release] AID - 10.1186/s12872-021-02265-2 [pii] AID - 2265 [pii] AID - 10.1186/s12872-021-02265-2 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2021 Sep 26;21(1):463. doi: 10.1186/s12872-021-02265-2.