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Original Research
The Effect of Type 2 Diabetes on Recurrent Major Cardiovascular Events for Patients With Symptomatic Vascular Disease at Different Locations
Manon C. Stam-Slob, Yolanda van der Graaf, Gert Jan de Borst, Maarten J. Cramer, L.J. Kappelle, Jan Westerink, Frank L. Visseren, on behalf of the SMART Study Group
Diabetes Care 2015 Jun; dc142900. https://doi.org/10.2337/dc14-2900
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Abstract

OBJECTIVE Our aim is to compare the effect of type 2 diabetes on recurrent major cardiovascular events (MCVE) for patients with symptomatic vascular disease at different locations.

RESEARCH DESIGN AND METHODS A total of 6,841 patients from the single-center, prospective Secondary Manifestations of ARTerial disease (SMART) cohort study from Utrecht, the Netherlands, with clinically manifest vascular disease with (n = 1,155) and without (n = 5,686) type 2 diabetes were monitored between 1996 and 2013. The effect of type 2 diabetes on recurrent MCVE was analyzed with Cox proportional hazard models, stratified for disease location (cerebrovascular disease, peripheral artery disease, abdominal aortic aneurysm, coronary artery disease, or polyvascular disease, defined as ≥2 vascular locations).

RESULTS Five-year risks for recurrent MCVE were 9% in cerebrovascular disease, 9% in peripheral artery disease, 20% in those with an abdominal aortic aneurysm, 7% in coronary artery disease, and 21% in polyvascular disease. Type 2 diabetes increased the risk of recurrent MCVE in coronary artery disease (hazard ratio [HR] 1.67; 95% CI 1.25–2.21) and seemed to increase the risk in cerebrovascular disease (HR 1.36; 95% CI 0.90–2.07), while being no risk factor in polyvascular disease (HR 1.12; 95% CI 0.83–1.50). Results for patients with peripheral artery disease (HR 1.42; 95% CI 0.79–2.56) or an abdominal aortic aneurysm (HR 0.93; 95% CI 0.23–3.68) were inconclusive.

CONCLUSIONS Type 2 diabetes increased the risk of recurrent MCVE in patients with coronary artery disease, but there is no convincing evidence that it is a major risk factor for subsequent MCVE in all patients with symptomatic vascular disease.

Footnotes

  • ↵* A list of the members of the SMART Study Group can be found in the Acknowledgments.

  • Received December 6, 2014.
  • Accepted April 7, 2015.
  • © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
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Diabetes Care: 44 (4)

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April 2021
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The Effect of Type 2 Diabetes on Recurrent Major Cardiovascular Events for Patients With Symptomatic Vascular Disease at Different Locations
Manon C. Stam-Slob, Yolanda van der Graaf, Gert Jan de Borst, Maarten J. Cramer, L.J. Kappelle, Jan Westerink, Frank L. Visseren, on behalf of the SMART Study Group
Diabetes Care Jun 2015, dc142900; DOI: 10.2337/dc14-2900

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The Effect of Type 2 Diabetes on Recurrent Major Cardiovascular Events for Patients With Symptomatic Vascular Disease at Different Locations
Manon C. Stam-Slob, Yolanda van der Graaf, Gert Jan de Borst, Maarten J. Cramer, L.J. Kappelle, Jan Westerink, Frank L. Visseren, on behalf of the SMART Study Group
Diabetes Care Jun 2015, dc142900; DOI: 10.2337/dc14-2900
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© 2021 by the American Diabetes Association. Diabetes Care Print ISSN: 0149-5992, Online ISSN: 1935-5548.