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Article Abstract
Background: Diabetes mellitus type 1 (DM1) and type 2 (DM2) are well-established risk factors for cardiovascular disease but differ pathophysiologically in that DM1 results from insulin deficiency, whereas DM2 results from insulin insensitivity. The association between DM1 and DM2 and cardiovascular events remains undetermined.
Methods: For DM1 or DM2 patients aged 46 to 75 years receiving care at outpatient facilities with primary care and/or endocrinology enrolled in the National Cardiovascular Data Registry Veradigm Metabolic Registry 2017-2022, we compared the prevalence of incident cardiovascular events including myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, stroke, carotid revascularization, limb ischemia, and peripheral revascularization.
Results: The study population included 5823 DM1 patients (3.59%) and 156,204 DM2 patients (95.41%) with a total of 758,643 visits. DM1 patients were younger and had fewer comorbidities. A total of 11,096 incident cardiovascular events occurred with a prevalence ratio (PR) of 0.63 (95% CI, 0.55-0.71) for fewer events associated with DM1 than DM2. After adjustment for age, the PR was 0.66 (95% CI, 0.58-0.74). When analyzed by separate cardiovascular events, DM1 was associated with less myocardial infarction, percutaneous coronary intervention, stroke, and limb ischemia than DM2. Overall cardiovascular event probability was lower in DM1 than in DM2 across all 10-year age categories, in both female and male patients, before and during/after the coronavirus disease 2019 pandemic, and after adjustment for comorbidities, hemoglobin A1c, and serum creatinine.
Conclusions: DM1 was associated with a lower probability of incident cardiovascular events than DM2. Although DM1 may carry a lower risk of incident cardiovascular events than DM2, the pathophysiology, prevention, and treatment of cardiovascular disease in DM1 remain poorly understood.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993881 | PMC |
| http://dx.doi.org/10.1016/j.jscai.2024.102502 | DOI Listing |
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