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Epidemiology/Health Services/Psychosocial Research

High Risk of Cardiovascular Disease in Patients With Type 1 Diabetes in the U.K.

A cohort study using the General Practice Research Database

  1. Sabita S. Soedamah-Muthu, PHD12,
  2. John H. Fuller, MD1,
  3. Henrietta E. Mulnier, MSC3,
  4. Veena S. Raleigh, PHD34,
  5. Ross A. Lawrenson, MD3 and
  6. Helen M. Colhoun, MD15
  1. 1Department of Epidemiology and Public Health, Royal Free and University College London Medical School, London, U.K.
  2. 2Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
  3. 3Postgraduate Medical School, University of Surrey, Guildford, Surrey, U.K.
  4. 4Healthcare Commission, Finsbury Tower, London, U.K.
  5. 5Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
  1. Address correspondence and reprint requests to S.S. Soedamah-Muthu, University Medical Centre Utrecht, Julius Center for Health Sciences and Primary Care, Huispostnr str.6.131, P.O. Box 85500, 3508 GA. Utrecht. E-mail: s.s.soedamah-muthu{at}umcutrecht.nl
Diabetes Care 2006 Apr; 29(4): 798-804. https://doi.org/10.2337/diacare.29.04.06.dc05-1433
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    Figure 1—

    Estimated 10-year fatal CVD risk by current (or attained) age in type 1 diabetic (t1d) men and women compared with nondiabetic comparison group (ctr).

Tables

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  • Table 1—

    Absolute and relative risk (HR) for first major CVD events in type 1 diabetic men and women and nondiabetic comparison group free of prior CVD

    nMen
    Women
    Type 1 diabetes
    Without diabetes
    Type 1 diabetes vs. comparison group
    Type 1 diabetes
    Without diabetes
    Type 1 diabetes vs. comparison group
    Absolute risk per 1,000 person-yearsAbsolute risk per 1,000 person-yearsHRAbsolute risk per 1,000 person-yearsAbsolute risk per 1,000 person-yearsHR
    Acute coronary events2693.5 (2.7–4.4)1.3 (1.1–1.5)3.0 (2.2–4.1)2.9 (2.2–3.9)0.5 (0.3–0.7)7.6 (4.9–12.0)
    Coronary revascularisations1132.0 (1.5–2.8)0.4 (0.3–0.6)5.0 (3.2–7.8)1.5 (1.0–2.3)0.1 (0.06–0.2)16.8 (7.5–37.5)
    Stroke (fatal + nonfatal)1992.7 (2.1–3.6)0.8 (0.7–1.0)3.7 (2.6–5.3)2.0 (1.4–2.8)0.5 (0.3–0.7)4.8 (3.0–7.9)
    Major CHD3525.1 (4.2–6.3)1.6 (1.4–1.9)3.6 (2.8–4.6)4.1 (3.2–5.2)0.5 (0.4–0.7)9.6 (6.4–14.5)
    Fatal CVD1672.8 (2.1–3.7)0.5 (0.4–0.7)5.8 (3.9–8.6)2.5 (1.9–3.5)0.3 (0.2–0.4)11.6 (6.7–20.1)
    Major CVD5087.3 (6.1–8.6)2.3 (2.0–2.6)3.6 (2.9–4.5)5.5 (4.4–6.8)0.9 (0.7–1.2)7.7 (5.5–10.7)
    • Data are risk (95% CI). Absolute risk is the absolute major CVD event rate expressed in person-years at risk. Acute coronary events defined as fatal and nonfatal myocardial infarction and acute CHD death. Coronary revascularizations defined as coronary artery bypass graft, percutaneous transluminal coronary angioplasty, other angioplasty, or other coronary surgery. Major CHD defined as fatal and nonfatal myocardial infarction, coronary revascularizations, and acute CHD death. Major CVD defined as fatal and nonfatal myocardial infarction, coronary revascularizations, acute CHD death, and fatal and nonfatal stroke. Fatal CVD defined as death due to myocardial infarction, acute CHD, or stroke. All HRs are stratified for the matching variables (year of birth and sex).

  • Table 2—

    Absolute and relative risk (HR) for major CVD in type 1 diabetic men and women compared with the nondiabetic comparison group stratified by (current) age bands

    Men
    Women
    Person-yearsCVDType 1 diabetes
    Without diabetes
    Type 1 diabetes vs. comparison group
    Person-yearsCVDType 1 diabetes
    Without diabetes
    Type 1 diabetes vs. comparison group
    Absolute risk per 1,000 person-yearsAbsolute risk per 1,000 person-yearsHRAbsolute risk per 1,000 person-yearsAbsolute risk per 1,000 person-yearsHR
    ≤35 years52,985100.8 (0.4–1.6)0.07 (0.02–0.2)11.3 (2.9–43.8)47,41660.5 (0.2–1.3)0.05 (0.01–0.2)9.8 (1.8–53.6)
    35–45 years29,715514.8 (3.2–7.1)1.1 (0.8–1.6)4.4 (2.5–7.6)21,323173.5 (2.1–6.1)0.2 (0.09–0.6)15.4 (5.0–47.3)
    45–55 years17,1438110.6 (7.3–15.2)3.6 (2.8–4.7)3.0 (1.9–4.8)13,3903410.2 (6.7–15.5)1.1 (0.6–1.9)10.1 (5.0–20.4)
    55–65 years8,16611439.4 (29.5–52.6)9.7 (7.7–12.3)4.1 (2.8–6.0)6,5354422.8 (15.0–34.7)3.9 (2.6–6.0)5.7 (3.2–10.4)
    65–75 years3,1285735.2 (21.6–57.5)15.3 (11.3–20.8)2.3 (1.3–4.1)3,1113038.7 (24.1–62.3)4.9 (2.8–8.4)8.3 (4.0–17.2)
    >75 years83037122.2 (69.4–215.2)34.2 (23.1–50.6)3.5 (1.6–7.3)7432587.3 (39.2–194.3)28.2 (18.0–44.2)4.0 (1.4–11.2)
    Total350156
    • Data are risk (95% CI). Absolute risk is the absolute major CVD event rate expressed in person-years at risk. All HRs are stratified by year of birth and sex.

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High Risk of Cardiovascular Disease in Patients With Type 1 Diabetes in the U.K.
Sabita S. Soedamah-Muthu, John H. Fuller, Henrietta E. Mulnier, Veena S. Raleigh, Ross A. Lawrenson, Helen M. Colhoun
Diabetes Care Apr 2006, 29 (4) 798-804; DOI: 10.2337/diacare.29.04.06.dc05-1433

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High Risk of Cardiovascular Disease in Patients With Type 1 Diabetes in the U.K.
Sabita S. Soedamah-Muthu, John H. Fuller, Henrietta E. Mulnier, Veena S. Raleigh, Ross A. Lawrenson, Helen M. Colhoun
Diabetes Care Apr 2006, 29 (4) 798-804; DOI: 10.2337/diacare.29.04.06.dc05-1433
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