Heart failure and CKD manifestation in type 2 diabetes

  • Birkeland KI & al.
  • Diabetes Obes Metab
  • 3 May 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In type 2 diabetes (T2D) patients without a history of cardiovascular- and renal disease (CVRD), heart failure (HF) and chronic kidney disease (CKD) were consistently the most frequent first CVRD manifestation and associated with significantly increased risk of mortality.

Why this matters

  • Findings show that cardiorenal disease (diagnosis of HF or CKD) is an important and potentially fatal complication in patients with T2D that needs improved preventive strategies.

Study design

  • This large population-based study included 772,336 CVRD-free patients with T2D using the health care data from 6 countries in Europe and Asia.
  • Funding: AstraZeneca.

Key results

  • 137,081 (18%) patients developed a first CVRD manifestation characterised by CKD (36%), HF (24%), stroke (16%), myocardial infarction (14%) and peripheral artery disease (10%).
  • Single presence of cardiorenal disease (HF or CKD) was associated with an increased risk of CV (HR, 2.02; 95% CI, 1.75-2.33) and all-cause mortality (HR, 2.05; 95% CI, 1.82-2.32).
  • HF and CKD were separately associated with a significantly increased risk of CV (HR, 2.30; 95% CI, 2.14-2.47 and HR, 1.88; 95% CI, 1.59-2.22, respectively) and all-cause mortality (HR, 2.76; 95% CI, 2.12-3.59 and HR, 1.79; 95% CI, 1.59-2.02, respectively).
  • Cardiorenal syndrome (combination of HF and CKD) was associated with a higher risk of CV (HR, 3.91; 95% CI, 3.02-5.07) and all-cause mortality (HR, 3.14; 95% CI, 2.90-3.40).

Limitations

  • Risk of residual confounding.