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Diabetes increased CAD risk in young, middle-aged women
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Diabetes significantly increased the risk for incident and fatal coronary artery disease in young and middle-aged women, according to recent data published in Diabetes Care. The presence of diabetes equalized the gender differences traditionally seen in coronary artery disease, the researchers wrote.
These findings were consistent across three cohorts with varying underlying risk factors for cardiovascular disease, according to Rita Rastogi Kalyani, MD, MHS, an endocrinologist at Johns Hopkins University School of Medicine, and colleagues.
“Our findings suggest that we need to work harder to prevent heart disease in women under 60 who have diabetes,” Kalyani said in a press release. “This study tells us that women of any age who have diabetes are at a high risk for coronary artery disease.”
Patient data were observed from those younger than 60 years without CAD at the time of enrollment in the GeneSTAR Study (n=1,448), Multi-Ethnic Study of Atherosclerosis (MESA; n=3,072) and National Health and Nutrition Examination Survey III Mortality Follow-up Study (n=6,997) to investigate gender differences in CAD.
Meta-analysis data demonstrate that women with diabetes had an approximately fourfold greater likelihood of CAD events at follow-up (HR=4.23; 95% CI, 2.57-6.95) compared with women without diabetes. However, men with diabetes compared with those without diabetes did not have increased CAD events (HR=1.3; 95% CI, 0.83-2.03), researchers wrote.
CAD event rates were lower among women compared with men in which neither gender cohort had diabetes:
- GeneSTAR (4.27 vs. 11.22 per 1,000 person-years);
- MESA (1.66 vs. 5.64 per 1,000 person-years); and
- NHANES (0.4 vs. 0.88 per 1,000 person-years).
CAD events were similar in women with diabetes vs. men with diabetes:
- GeneSTAR (17.65 vs. 12.86 per 1,000 person-years);
- MESA (7.34 vs. 9.71 per 1,000 person-years); and
- NHANES (2.37 vs. 1.83 per 1,000 person-years).
“We are the first to demonstrate that diabetes equalizes the risk of coronary artery disease by gender, specifically among healthy young- and middle-aged adults with different underlying risks for heart disease,” the researchers wrote.
“Our study adds to the growing body of evidence that gender differences exist in the risk of coronary artery disease brought on by diabetes,” Kalyani said in the release.
Disclosure: Vaidya reports consultancy for MyBodyCount. All other researchers report no relevant financial disclosures.
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