Mortality rates after first MI declining in type 2 diabetes, but not type 1 diabetes
Click Here to Manage Email Alerts
Key takeaways:
- All-cause and CV mortality rates after an incident MI declined from 2006 to 2020 for adults with type 2 diabetes.
- Adults with type 1 diabetes have had no changes in mortality rates after first MI.
All-cause and cardiovascular mortality rates remained flat from 2006 to 2020 for people with type 1 diabetes who had a first-time myocardial infarction, despite mortality rates declining for type 2 diabetes, according to two presenters.
In data that will be presented at the European Association for the Study of Diabetes annual meeting, rates for all-cause mortality and CV deaths and major adverse events after a first-time MI have declined annually for people without diabetes and those with type 2 diabetes from 2006 to 2020. However, adults with type 1 diabetes have had no change in mortality or major adverse CV event risk following a first MI during that same period.
“Since this is an observational study, we cannot tell anything about causality,” Thomas Nyström, MD, professor in the department of clinical science and education at Karolinska Institutet in Stockholm, told Healio. “However, the lack of a significant declined mortality trend in people with type 1 diabetes after having a first MI is of importance, and diabetologists and cardiologists must pay attention to it.”
Researchers obtained data from national health registries of 243,170 people without diabetes (mean age, 73 years; 38.1% women), 48,321 people with type 2 diabetes (mean age, 75 years; 38.1% women) and 2,527 with type 1 diabetes (mean age, 62 years; 43.6% women) who had a first-time MI 2006 2020. Researchers collected all-cause mortality, CV death and major adverse CV events, which was a composite of nonfatal stroke, nonfatal MI, CV death and hospitalization for heart failure. The maximum follow-up period for each adult was 1,095 days. HRs were estimated in 3-year blocks and continuously from the date each person entered the study.
The proportion of MI that classified as ST-elevation was 29% in adults with type 1 diabetes, 30% in those with type 2 diabetes and 39% in adults without diabetes. After adjusting for multiple variables, adults without diabetes had an annual decrease in all-cause mortality following MI of 1.9%. Adults with type 2 diabetes also had an all-cause mortality decline of 1.3% annually. No change in all-cause mortality following MI was observed for those with type 1 diabetes.
Rates of CV death following first MI declined by 2% annually for people without diabetes and by 1.6% for those with type 2 diabetes, with no significant change observed among adults with type 1 diabetes. Major adverse CV event rates decreased annually by 2.3% for people without diabetes and by 1.9% for adults with type 2 diabetes compared with no change in the type 1 diabetes group.
“Further studies are needed investigating, for example, novel biomarkers for CV mortality risk in people with type 1 diabetes,” Nyström said. “Also, studies investigating the basis for cardiovascular disease in people with type 1 diabetes in comparison with type 2 diabetes and non-diabetes individuals are much appreciated.”
Collapse
Wedén L, et al. Abstract 169. Presented at: European Association for the Study of Diabetes Annual Meeting; Oct. 2-6, 2023; Hamburg, Germany.
Click Here to Manage Email Alerts