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Characteristics and Prognosis in Women and Men With Type 1 Diabetes Undergoing Coronary Angiography: A Nationwide Registry Report
Karolinska Inst, Dept Med Solna, Cardiol Unit, Stockholm, Sweden.;Dept Res & Dev, Region Kronoberg, Vaxjo, Sweden..
Univ Gothenburg, Sahlgrenska Univ Hosp, Dept Med, Gothenburg, Sweden..ORCID iD: 0000-0001-7090-8952
Natl Diabet Register, Ctr Registers, Gothenburg, Sweden..
Karolinska Inst, Dept Med Solna, Cardiol Unit, Stockholm, Sweden..
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2018 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 41, no 4, p. 876-883Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To describe sex aspects on extent of coronary artery disease (CAD) and prognosis in a contemporary population with type 1 diabetes.

RESEARCH DESIGN AND METHODS: All patients undergoing coronary angiography, 2001-2013, included in the Swedish Coronary Angiography and Angioplasty Registry and the Swedish National Diabetes Register as type 1 diabetes were followed for mortality until 31 December 2013. The coronary angiogram was classified into normal, one-vessel disease, two-vessel disease, three-vessel disease, and left main stem disease.

RESULTS: In all, 2,776 patients (42% women) with mean age 58 years (SD 11) were followed for 7.2 years (SD 2.2). Diabetes duration was longer in women (37 14 vs. 34 +/- 14 years in men; P < 0.001), who also had more retinopathy (68% vs. 65%; P = 0.050), whereas microalbuminuria was less common (41% vs. 51%; P < 0.001). Indications for coronary angiography did not substantially differ in women and men. The extent of CAD was somewhat less severe in women (normal angiogram 23.5% vs. 19.1%, three-vessel and left main stem disease 34.5% vs. 40.4%; P = 0.002), whereas mortality did not differ (adjusted hazard ratio 1.03 [95% CI 0.88-1.20]; P = 0.754). The standard mortality ratio for women the first year was 7.49 (5.73-9.62) and for men was 4.58 (3.60-5.74).

CONCLUSIONS: In patients with type 1 diabetes admitted for coronary angiography, the extent of CAD was almost similar in women and men, and total long-term mortality did not differ. Type 1 diabetes was associated with higher mortality risk in women than in men when compared with the general population. These data support that type 1 diabetes attenuates the cardiovascular risk difference seen in men and women in the general population.

Place, publisher, year, edition, pages
AMER DIABETES ASSOC , 2018. Vol. 41, no 4, p. 876-883
National Category
Endocrinology and Diabetes Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-351572DOI: 10.2337/dc17-2352ISI: 000428000000050PubMedID: 29463579OAI: oai:DiVA.org:uu-351572DiVA, id: diva2:1210937
Funder
The Kamprad Family FoundationSwedish Diabetes AssociationSwedish Heart Lung FoundationAvailable from: 2018-05-30 Created: 2018-05-30 Last updated: 2018-05-30Bibliographically approved

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