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December 08, 2020
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Stroke, fatal MI risk high for most patients with type 2 diabetes

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Patients with type 2 diabetes had a high or very high risk for fatal MI or stroke, according to a study published in the European Journal of Preventive Cardiology.

“In terms of CV risk, diabetes and CVD have been described as ‘two bad companions.’ However, whether the risk of subsequent adverse CV events in patients with diabetes equals to that of those with previous CVD has been long debated,” Manel Mata-Cases, PhD, general practitioner for the Catalan Institute of Health in Sant Adria de Besos, Spain, and colleagues wrote. “We hypothesized in the present study that most of type 2 diabetes patients might be at very high CV risk analyzing a large population in a region of a low-risk European country.”

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In a cross-sectional study, researchers utilized the Information System for the Development of Research in Primary Care database to identify patients diagnosed with type 2 diabetes. Of 373,185 patients (mean age, 70.1 years; 45.2% women), CV risk factor analysis found 72% had hypertension, 45% were classified as obese, 60% had dyslipidemia and 14% were current smokers. Investigators calculated the likelihood of fatal MI or stroke within 10 years and categorized each participant as very high risk (> 10% risk), high risk (5% to 10% risk) or moderate risk (< 5% risk).

Study results showed 53.4% of participants had a very high risk for fatal events, with higher risk observed in men compared with women (55.6% vs. 50.7%). Further results showed 39.6% of participants had a high risk for mortality within 10 years and 7% of participants had a moderate risk for mortality within 10 years.

“The most striking result of our study was that the vast majority of patients (93%) had a high or very high risk of fatal events within a decade. Half of patients in the very high-risk group had no history of heart disease, meaning they would not be receiving medications to prevent heart attacks and strokes. ... These findings in a primary care setting should fuel the implementation of integrated care,” Mata-Cases said in a press release. “General practitioners and nurses should agree treatment objectives with patients considering their characteristics and preferences.”