Frequency of cardiovascular complications in patients with type 2 diabetes mellitus depending on antihyperglycemic therapy
Background. The purpose of the study was to determine the frequency of cardiovascular complications in patients with type 2 diabetes mellitus (DM) depending on the type of antihyperglycemic therapy. Materials and methods. Patients were divided into 3 groups: first group — all patients with type 2 DM included in the study (n = 1999), second group were patients (n = 201) with DM with myocardial infarction from the first group, third group were patients with DM with stroke from the first group (n = 155). Results. It was found that actually every second patient in the second group had angina pectoris — 48.3 % that is 2.7 times higher of the same index in the first group (18.2 %) and 1.7 times — in the third group (29.0 %). Every fifth patient in the second and third groups had heart rhythm disorder (in the first group — 11.2 %, in the second group — 20.9 %, in the third group — 20.7 %), its incidence was highest in men of this group (27.7 and 23.1 %, respectively). Arterial hypertension is the third common in the structure of concomitant cardiovascular pathology in patients with DM, more often in patients of the third group (in the first group — 74.6 %, in the second group — 76.6 %, in the third group — 80.7 %), most often in women in every group (78.7, 84.3 and 84.4 %, respectively). Coronary artery bypass surgery is conducted in 38 patients, the proportion among other operative interventions is highest in the second group (in the first group — 11.9 %, in the second group — 12.7 %, in the third group — 9.8 %). Conclusions. The proportion of patients who received monotherapy with insulin preparations is highest in the second group (17.4 %), actually at one level — in the first and third groups (12.8 and 12.3 %, respectively). The majority of patients in the first group received monotherapy with oral hypoglycemic agents (56.2 against 46.2 % in the second group and 49.7 % — in the third group), due to an increase in the proportion of patients with insulin monotherapy. Every third patient in the second and third groups (34.3 and 34.8 %, respectively) received combined therapy with insulins and oral hypoglycemic preparations.
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Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2014. Available from: https://www.cdc.gov/diabetes/pdfs/data/2014-report-estimates-of-diabetes-and-its-burden-in-the-united-states.pdf.
Beckman JA, Paneni F, Cosentino F, Creager MA. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part II. Eur Heart J. 2013 Aug;34(31):2444-52. doi: 10.1093/eurheartj/eht142.
Low Wang CC, Hess CN, Hiatt WR, Goldfine AB. Clinical update: cardiovascular disease in diabetes mellitus: atherosclerotic cardiovascular disease and heart failure in type 2 diabetes mellitus – mechanisms, management, and clinical considerations. Circulation. 2016 Jun 14;133(24):2459-502. doi: 10.1161/CIRCULATIONAHA.116.022194.
Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017 Mar 7;135(10):e146-e603. doi: 10.1161/CIR.0000000000000485.
Emerging Risk Factors Collaboration, Sarwar N, Gao P, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010 Jun 26;375(9733):2215-22. doi: 10.1016/S0140-6736(10)60484-9.
Shu L, Chan KHK, Zhang G, et al. Shared genetic regulatory networks for cardiovascular disease and type 2 diabetes in multiple populations of diverse ethnicities in the United States. PLoS Genet. 2017 Sep 28;13(9):e1007040. doi: 10.1371/journal.pgen.1007040.
Davies MJ, D'Alessio DA, Fradkin J, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018 Oct 4. pii: dci180033. doi: 10.2337/dci18-0033.
Jabbour SA, Frías JP, Hardy E, et al. Safety and Efficacy of Exenatide Once Weekly Plus Dapagliflozin Once Daily Versus Exenatide or Dapagliflozin Alone in Patients With Type 2 Diabetes Inadequately Controlled With Metformin Monotherapy: 52-Week Results of the DURATION-8 Randomized Controlled Trial. Diabetes Care. 2018 Oct;41(10):2136-2146. doi: 10.2337/dc18-0680.
Inzucchi SE, Zinman B, Fitchett D, et al. How does empagliflozin reduce cardiovascular mortality? Insights from a mediation analysis of the EMPA-REG OUTCOME trial. Diabetes Care. 2018 Feb;41(2):356-363. doi: 10.2337/dc17-1096.
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