OBJECTIVE Trends in cardiac risk and death have not been examined in
patients with incident type 2 diabetes and no prior cardiovascular disease.
Therefore, we aimed to examine trends in cardiac risk and death in relation to
use of prophylactic cardiovascular medications in patients with incident
type 2 diabetes without prior cardiovascular disease.
<p>RESEARCH DESIGN AND METHODS In this population-based cohort study, we
included patients with incident type 2 diabetes between 1996 and
2011 through national health registries. Each patient was matched by age and
sex with up to 5 persons without diabetes from the general population. All individuals
were followed for 7 years.</p>
<p>RESULTS We identified 209,311 patients with incident diabetes. From 1996-1999
to 2008-2011, the
7-year risk of myocardial infarction decreased from 6.9% to 2.8% (adjusted hazard ratio [aHR] 0.39, 95% CI 0.37-0.42), cardiac
death from 7.1% to 1.6% (aHR 0.23, 95% CI 0.21-0.24), and all-cause death from
28.9% to 16.8% (aHR 0.68, 95% CI 0.66-0.69). Compared to the general
population, 7-year risk differences decreased from 3.3% to 0.8% for myocardial
infarction, from 2.7% to 0.5% for cardiac death, and from 10.6% to 6.0% for all-cause
death. Use of cardiovascular medications within ±1 year of diabetes
diagnosis, especially
statins (5% users in 1996-1999 vs. 60% in 2008-2011), increased during the
study period.</p>
<p>CONCLUSIONS From 1996 to 2011, Danish patients with incident type 2
diabetes and no prior cardiovascular disease experienced major reductions in
cardiac risk and mortality. The risk reductions coincided with increased use of
prophylactic cardiovascular medications. </p>
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<p> </p>
Nationwide Trends in Cardiac Risk and Mortality in Patients With Incident Type 2 Diabetes: A Danish Cohort Study
