- Excess risks for acute myocardial infarction (AMI) and coronary heart disease (CHD) death in patients with type 2 diabetes (T2D) without prior AMI are seen primarily in patients with worsening glucose control and renal function.
- Excess risk is greatly attenuated in patients with on-target HbA1c without renal complications.
Why this matters
- Cardiovascular disease is the major contributor to excess death in T2D.
- Included 431,579 patients with T2D in the Swedish National Diabetes Register, 1998-2012, and 2,173,620 general population controls.
- Funding: Swedish Society of Medicine; Swedish State; Swedish Research Council.
- Coronary events per 1000 person-years were 14.64 among persons with T2D (8.4%) and 8.73 in controls (5.3%).
- After adjustments for sex, age, diabetes duration, country, education, and comorbidities, HR for AMI and CHD death was 1.42 for those with vs without T2D (95% CI, 1.41-1.44).
- HRs for coronary events decreased with older age and were lower for men vs women across age groups.
- With T2D and mean HbA1c 6.9%, normoalbuminuria, and estimated glomerular filtration rate ≥60 mL/minute/1.73 m2, HRs for coronary events were 0.94 (P=.0014) for men and 0.98 (P=.56) for women, vs controls.
- Some relevant variables were unavailable.
- Possible residual confounders.
- All-Swedish population.