Diabetes and risk of peripheral artery disease in patients undergoing first-time coronary angiography between 2000 and 2012: a nationwide study

Sadaf Kamil; Thomas S. G. Sehested; Nicholas Carlson; Kim Houlind; Jens F. Lassen; Casper N. Bang; Helena Dominguez; Christian T. Pedersen; Gunnar H. Gislason

doi:10.1186/s12872-019-1213-1

Diabetes and risk of peripheral artery disease in patients undergoing first-time coronary angiography between 2000 and 2012: a nationwide study

Sadaf Kamil, Thomas S. G. Sehested, Nicholas Carlson, Kim Houlind, Jens F. Lassen, Casper N. Bang, Helena Dominguez, Christian T. Pedersen, Gunnar H. Gislason

8 Citations (Scopus)

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Abstract

Background The risk of peripheral artery disease (PAD) in patients with diabetes mellitus (DM) and coronary artery disease (CAD) is an important and inadequately addressed issue. Our aim is to examine the impact of DM on risk of PAD in patients with different degrees of CAD characterized by coronary angiography (CAG). Methods Using nationwide registers we identified all patients aged >= 18 years, undergoing first time CAG between 2000 and 2012. Patients were categorized into DM/Non-DM group, and further classified into categories according to the degree of CAD i.e., no-vessel disease, single-vessel disease, double-vessel disease, triple-vessel disease, and diffuse disease. Risk of PAD was estimated by 5-year cumulative-incidence and adjusted multivariable Cox-regression models. Results We identified 116,491 patients undergoing first-time CAG. Among these, a total of 23.969 (20.58%) had DM. Cumulative-incidence of PAD among DM patients vs. non-DM were 8.8% vs. 4.9% for no-vessel disease, 8.2% vs. 4.8% for single-vessel disease, 10.2% vs. 6.0% for double-vessel disease, 13.0% vs. 8.4% for triple-vessel disease, and 6.8% vs. 6.1% for diffuse disease, respectively. For all patients with DM, the cox-regression analysis yielded significantly higher hazards of PAD compared with non-DM patients with HR 1.70 (no-vessel disease), 1.96 (single-vessel disease), 2.35 (double-vessel disease), 2.87 (triple-vessel disease), and 1.46 (diffuse disease), respectively (interaction-p 0.042). Conclusion DM appears to be associated with increased risk of PAD in patients with and without established CAD, with increasing risk in more extensive CAD. This observation indicates awareness on PAD risk in patients with DM, especially among patients with advanced CAD.

Original language	English
Article number	234
Journal	BMC Cardiovascular Disorders
Volume	19
Issue number	1
Number of pages	9
ISSN	1471-2261
DOIs	https://doi.org/10.1186/s12872-019-1213-1
Publication status	Published - 24 Oct 2019

Keywords

Type 2 diabetes mellitus
Peripheral artery disease
Coronary artery disease
Atherosclerosis

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Cite this

Kamil, S., Sehested, T. S. G., Carlson, N., Houlind, K., Lassen, J. F., Bang, C. N., Dominguez, H., Pedersen, C. T., & Gislason, G. H. (2019). Diabetes and risk of peripheral artery disease in patients undergoing first-time coronary angiography between 2000 and 2012: a nationwide study. BMC Cardiovascular Disorders, 19(1), Article 234. https://doi.org/10.1186/s12872-019-1213-1

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title = "Diabetes and risk of peripheral artery disease in patients undergoing first-time coronary angiography between 2000 and 2012: a nationwide study",

abstract = "Background The risk of peripheral artery disease (PAD) in patients with diabetes mellitus (DM) and coronary artery disease (CAD) is an important and inadequately addressed issue. Our aim is to examine the impact of DM on risk of PAD in patients with different degrees of CAD characterized by coronary angiography (CAG). Methods Using nationwide registers we identified all patients aged >= 18 years, undergoing first time CAG between 2000 and 2012. Patients were categorized into DM/Non-DM group, and further classified into categories according to the degree of CAD i.e., no-vessel disease, single-vessel disease, double-vessel disease, triple-vessel disease, and diffuse disease. Risk of PAD was estimated by 5-year cumulative-incidence and adjusted multivariable Cox-regression models. Results We identified 116,491 patients undergoing first-time CAG. Among these, a total of 23.969 (20.58%) had DM. Cumulative-incidence of PAD among DM patients vs. non-DM were 8.8% vs. 4.9% for no-vessel disease, 8.2% vs. 4.8% for single-vessel disease, 10.2% vs. 6.0% for double-vessel disease, 13.0% vs. 8.4% for triple-vessel disease, and 6.8% vs. 6.1% for diffuse disease, respectively. For all patients with DM, the cox-regression analysis yielded significantly higher hazards of PAD compared with non-DM patients with HR 1.70 (no-vessel disease), 1.96 (single-vessel disease), 2.35 (double-vessel disease), 2.87 (triple-vessel disease), and 1.46 (diffuse disease), respectively (interaction-p 0.042). Conclusion DM appears to be associated with increased risk of PAD in patients with and without established CAD, with increasing risk in more extensive CAD. This observation indicates awareness on PAD risk in patients with DM, especially among patients with advanced CAD.",

keywords = "Type 2 diabetes mellitus, Peripheral artery disease, Coronary artery disease, Atherosclerosis",

author = "Sadaf Kamil and Sehested, {Thomas S. G.} and Nicholas Carlson and Kim Houlind and Lassen, {Jens F.} and Bang, {Casper N.} and Helena Dominguez and Pedersen, {Christian T.} and Gislason, {Gunnar H.}",

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doi = "10.1186/s12872-019-1213-1",

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TY - JOUR

T1 - Diabetes and risk of peripheral artery disease in patients undergoing first-time coronary angiography between 2000 and 2012

T2 - a nationwide study

AU - Kamil, Sadaf

AU - Sehested, Thomas S. G.

AU - Carlson, Nicholas

AU - Houlind, Kim

AU - Lassen, Jens F.

AU - Bang, Casper N.

AU - Dominguez, Helena

AU - Pedersen, Christian T.

AU - Gislason, Gunnar H.

PY - 2019/10/24

Y1 - 2019/10/24

N2 - Background The risk of peripheral artery disease (PAD) in patients with diabetes mellitus (DM) and coronary artery disease (CAD) is an important and inadequately addressed issue. Our aim is to examine the impact of DM on risk of PAD in patients with different degrees of CAD characterized by coronary angiography (CAG). Methods Using nationwide registers we identified all patients aged >= 18 years, undergoing first time CAG between 2000 and 2012. Patients were categorized into DM/Non-DM group, and further classified into categories according to the degree of CAD i.e., no-vessel disease, single-vessel disease, double-vessel disease, triple-vessel disease, and diffuse disease. Risk of PAD was estimated by 5-year cumulative-incidence and adjusted multivariable Cox-regression models. Results We identified 116,491 patients undergoing first-time CAG. Among these, a total of 23.969 (20.58%) had DM. Cumulative-incidence of PAD among DM patients vs. non-DM were 8.8% vs. 4.9% for no-vessel disease, 8.2% vs. 4.8% for single-vessel disease, 10.2% vs. 6.0% for double-vessel disease, 13.0% vs. 8.4% for triple-vessel disease, and 6.8% vs. 6.1% for diffuse disease, respectively. For all patients with DM, the cox-regression analysis yielded significantly higher hazards of PAD compared with non-DM patients with HR 1.70 (no-vessel disease), 1.96 (single-vessel disease), 2.35 (double-vessel disease), 2.87 (triple-vessel disease), and 1.46 (diffuse disease), respectively (interaction-p 0.042). Conclusion DM appears to be associated with increased risk of PAD in patients with and without established CAD, with increasing risk in more extensive CAD. This observation indicates awareness on PAD risk in patients with DM, especially among patients with advanced CAD.

AB - Background The risk of peripheral artery disease (PAD) in patients with diabetes mellitus (DM) and coronary artery disease (CAD) is an important and inadequately addressed issue. Our aim is to examine the impact of DM on risk of PAD in patients with different degrees of CAD characterized by coronary angiography (CAG). Methods Using nationwide registers we identified all patients aged >= 18 years, undergoing first time CAG between 2000 and 2012. Patients were categorized into DM/Non-DM group, and further classified into categories according to the degree of CAD i.e., no-vessel disease, single-vessel disease, double-vessel disease, triple-vessel disease, and diffuse disease. Risk of PAD was estimated by 5-year cumulative-incidence and adjusted multivariable Cox-regression models. Results We identified 116,491 patients undergoing first-time CAG. Among these, a total of 23.969 (20.58%) had DM. Cumulative-incidence of PAD among DM patients vs. non-DM were 8.8% vs. 4.9% for no-vessel disease, 8.2% vs. 4.8% for single-vessel disease, 10.2% vs. 6.0% for double-vessel disease, 13.0% vs. 8.4% for triple-vessel disease, and 6.8% vs. 6.1% for diffuse disease, respectively. For all patients with DM, the cox-regression analysis yielded significantly higher hazards of PAD compared with non-DM patients with HR 1.70 (no-vessel disease), 1.96 (single-vessel disease), 2.35 (double-vessel disease), 2.87 (triple-vessel disease), and 1.46 (diffuse disease), respectively (interaction-p 0.042). Conclusion DM appears to be associated with increased risk of PAD in patients with and without established CAD, with increasing risk in more extensive CAD. This observation indicates awareness on PAD risk in patients with DM, especially among patients with advanced CAD.

KW - Type 2 diabetes mellitus

KW - Peripheral artery disease

KW - Coronary artery disease

KW - Atherosclerosis

U2 - 10.1186/s12872-019-1213-1

DO - 10.1186/s12872-019-1213-1

M3 - Journal article

C2 - 31651241

SN - 1471-2261

VL - 19

JO - BMC Cardiovascular Disorders

JF - BMC Cardiovascular Disorders

IS - 1

M1 - 234

ER -