PMID- 34782334 OWN - NLM STAT- MEDLINE DCOM- 20211230 LR - 20211230 IS - 2052-4897 (Electronic) IS - 2052-4897 (Linking) VI - 9 IP - 2 DP - 2021 Nov TI - Type 2 diabetes and the risk of cardiovascular events in peripheral artery disease versus coronary artery disease. LID - 10.1136/bmjdrc-2021-002407 [doi] LID - e002407 AB - INTRODUCTION: The prevalence of type 2 diabetes mellitus (T2DM) is higher in peripheral artery disease (PAD) than in coronary artery disease (CAD) patients, and PAD overall confers higher cardiovascular risk than CAD. How cardiovascular risk compares between PAD and CAD patients when analyses are stratified by the presence of type 2 diabetes is unclear and is addressed in the present study. RESEARCH DESIGN AND METHODS: We prospectively recorded major cardiovascular events (MACE; ie, cardiovascular death, myocardial infarction or stroke) over 10.0+/-4.7 years in 923 patients with stable CAD, of whom 26.7% had T2DM and in 292 patients with PAD, of whom 42.1% had T2DM. Four groups were analyzed: CAD patients without diabetes (CAD/T2DM-; n=677), CAD patients with T2DM (CAD/T2DM+; n=246), PAD patients without diabetes (PAD/T2DM-; n=169) and PAD patients with T2DM (PAD/T2DM+; n=123). RESULTS: The event rate for MACE increased over our four investigated groups: it was lowest in CAD/T2DM- patients (2.52 events per 100 person-years). It was significantly higher in CAD/T2DM+ patients (3.96 events per 100 person-years; p<0.001), in PAD/T2DM- patients (3.68 events per 100 person-years; p=0.022), and in PAD/T2DM+ patients (7.10 events per 100 person-years; p<0.001), who in turn were at a higher risk than CAD/T2DM+ or PAD/T2DM- patients (p=0.001 and p<0.001, respectively). Cox regression analysis after multivariate adjustment showed that the presence of T2DM (HR=1.44 (95% CI 1.09 to 1.92); p=0.012) and the presence of PAD versus CAD (HR=1.48 (95% CI 1.15 to 1.91); p=0.002) were mutually independent predictors of cardiovascular events. CONCLUSIONS: In conclusion, our data show that T2DM as well as the presence of PAD versus CAD are mutually independent predictors of MACE. Patients with both PAD and T2DM are at an exceedingly high risk of cardiovascular events. CI - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Sprenger, Lukas AU - Sprenger L AUID- ORCID: 0000-0003-3798-048X AD - VIVIT, Vorarlberg Institute of Vascular Investigation and Treatment, Feldkirch, Vorarlberg, Austria. AD - Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Vorarlberg, Austria. AD - Private University in the Principality of Liechtenstein, Triesen, Liechtenstein. FAU - Mader, Arthur AU - Mader A AD - VIVIT, Vorarlberg Institute of Vascular Investigation and Treatment, Feldkirch, Vorarlberg, Austria. AD - Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Vorarlberg, Austria. AD - Private University in the Principality of Liechtenstein, Triesen, Liechtenstein. FAU - Larcher, Barbara AU - Larcher B AD - VIVIT, Vorarlberg Institute of Vascular Investigation and Treatment, Feldkirch, Vorarlberg, Austria. AD - Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Vorarlberg, Austria. AD - Private University in the Principality of Liechtenstein, Triesen, Liechtenstein. FAU - Machler, Maximilian AU - Machler M AD - VIVIT, Vorarlberg Institute of Vascular Investigation and Treatment, Feldkirch, Vorarlberg, Austria. AD - Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Vorarlberg, Austria. AD - Private University in the Principality of Liechtenstein, Triesen, Liechtenstein. FAU - Vonbank, Alexander AU - Vonbank A AD - VIVIT, Vorarlberg Institute of Vascular Investigation and Treatment, Feldkirch, Vorarlberg, Austria. AD - Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Vorarlberg, Austria. AD - Private University in the Principality of Liechtenstein, Triesen, Liechtenstein. FAU - Zanolin-Purin, Daniela AU - Zanolin-Purin D AD - VIVIT, Vorarlberg Institute of Vascular Investigation and Treatment, Feldkirch, Vorarlberg, Austria. AD - Private University in the Principality of Liechtenstein, Triesen, Liechtenstein. FAU - Leiherer, Andreas AU - Leiherer A AUID- ORCID: 0000-0003-3776-5704 AD - VIVIT, Vorarlberg Institute of Vascular Investigation and Treatment, Feldkirch, Vorarlberg, Austria. AD - Private University in the Principality of Liechtenstein, Triesen, Liechtenstein. FAU - Muendlein, Axel AU - Muendlein A AD - VIVIT, Vorarlberg Institute of Vascular Investigation and Treatment, Feldkirch, Vorarlberg, Austria. AD - Private University in the Principality of Liechtenstein, Triesen, Liechtenstein. FAU - Drexel, Heinz AU - Drexel H AUID- ORCID: 0000-0002-4677-9756 AD - VIVIT, Vorarlberg Institute of Vascular Investigation and Treatment, Feldkirch, Vorarlberg, Austria. AD - Private University in the Principality of Liechtenstein, Triesen, Liechtenstein. AD - Drexel University College of Medicine, Philadelphia, Pennsylvania, USA. AD - Department of Medicine, County Hospital Bregenz, Bregenz, Vorarlberg, Austria. FAU - Saely, Christoph H AU - Saely CH AD - VIVIT, Vorarlberg Institute of Vascular Investigation and Treatment, Feldkirch, Vorarlberg, Austria christoph.saely@icloud.com. AD - Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Vorarlberg, Austria. AD - Private University in the Principality of Liechtenstein, Triesen, Liechtenstein. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - BMJ Open Diabetes Res Care JT - BMJ open diabetes research & care JID - 101641391 SB - IM MH - *Coronary Artery Disease/epidemiology MH - *Diabetes Mellitus, Type 2/complications/epidemiology MH - Humans MH - *Myocardial Infarction/epidemiology/etiology MH - *Peripheral Arterial Disease/epidemiology MH - Risk Factors PMC - PMC8593703 OTO - NOTNLM OT - coronary artery disease OT - diabetes mellitus OT - peripheral arterial disease OT - risk factors OT - type 2 COIS- Competing interests: None declared. EDAT- 2021/11/17 06:00 MHDA- 2021/12/31 06:00 PMCR- 2021/11/15 CRDT- 2021/11/16 06:11 PHST- 2021/05/27 00:00 [received] PHST- 2021/09/18 00:00 [accepted] PHST- 2021/11/16 06:11 [entrez] PHST- 2021/11/17 06:00 [pubmed] PHST- 2021/12/31 06:00 [medline] PHST- 2021/11/15 00:00 [pmc-release] AID - 9/2/e002407 [pii] AID - bmjdrc-2021-002407 [pii] AID - 10.1136/bmjdrc-2021-002407 [doi] PST - ppublish SO - BMJ Open Diabetes Res Care. 2021 Nov;9(2):e002407. doi: 10.1136/bmjdrc-2021-002407.