Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N, 8200, Denmark.
Cardiovasc Diabetol. 2021 Jan 21;20(1):23. doi: 10.1186/s12933-021-01212-x.
Diabetes patients without obstructive coronary artery disease as assessed by coronary angiography have a low risk of myocardial infarction, but their myocardial infarction risk may still be higher than the general population. We examined the 10-year risks of myocardial infarction, ischemic stroke, and death in diabetes patients without obstructive coronary artery disease according to coronary angiography, compared to risks in a matched general population cohort.
We included all diabetes patients without obstructive coronary artery disease examined by coronary angiography from 2003 to 2016 in Western Denmark. Patients were matched by age and sex with a cohort from the Western Denmark general population without a previous myocardial infarction or coronary revascularization. Outcomes were myocardial infarction, ischemic stroke, and death. Ten-year cumulative incidences were computed. Adjusted hazard ratios (HR) then were computed using stratified Cox regression with the general population as reference.
We identified 5734 diabetes patients without obstructive coronary artery disease and 28,670 matched individuals from the general population. Median follow-up was 7 years. Diabetes patients without obstructive coronary artery disease had an almost similar 10-year risk of myocardial infarction (3.2% vs 2.9%, adjusted HR 0.93, 95% CI 0.72-1.20) compared to the general population, but had an increased risk of ischemic stroke (5.2% vs 2.2%, adjusted HR 1.87, 95% CI 1.47-2.38) and death (29.6% vs 17.8%, adjusted HR 1.24, 95% CI 1.13-1.36).
Patients with diabetes and no obstructive coronary artery disease have a 10-year risk of myocardial infarction that is similar to that found in the general population. However, they still remain at increased risk of ischemic stroke and death.
经冠状动脉造影评估无阻塞性冠状动脉疾病的糖尿病患者发生心肌梗死的风险较低，但他们的心肌梗死风险仍可能高于普通人群。我们根据冠状动脉造影检查，比较了无阻塞性冠状动脉疾病的糖尿病患者与匹配的普通人群队列的 10 年心肌梗死、缺血性卒中和死亡风险。
我们纳入了 2003 年至 2016 年期间在丹麦西部接受冠状动脉造影检查的所有无阻塞性冠状动脉疾病的糖尿病患者。患者按年龄和性别与没有既往心肌梗死或冠状动脉血运重建的丹麦西部普通人群队列进行匹配。结局为心肌梗死、缺血性卒中和死亡。计算了 10 年累积发生率。然后使用分层 Cox 回归，以普通人群为参照，计算调整后的风险比（HR）。
我们确定了 5734 名无阻塞性冠状动脉疾病的糖尿病患者和 28670 名来自普通人群的匹配个体。中位随访时间为 7 年。与普通人群相比，无阻塞性冠状动脉疾病的糖尿病患者的 10 年心肌梗死风险几乎相似（3.2%比 2.9%，调整 HR 0.93，95%CI 0.72-1.20），但缺血性卒中和死亡风险增加（5.2%比 2.2%，调整 HR 1.87，95%CI 1.47-2.38 和 29.6%比 17.8%，调整 HR 1.24，95%CI 1.13-1.36）。
无阻塞性冠状动脉疾病的糖尿病患者的 10 年心肌梗死风险与普通人群相似。然而，他们仍然存在更高的缺血性卒中和死亡风险。
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