Panchal Kajal, Lawson Claire, Shabnam Sharmin, Khunti Kamlesh, Zaccardi Francesco
Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, UK.
Department of Cardiovascular Sciences, University of Leicester, UK.
Diabetes Res Clin Pract. 2025 Feb;220:111980. doi: 10.1016/j.diabres.2024.111980. Epub 2024 Dec 30.
To investigate trends in ischaemic and non-ischaemic heart failure (HF) in adults with type 2 diabetes and without diabetes between 1st January 2000 and 31st December 2019 in England.
We used the Clinical Practice Research Datalink datasets, linked to the Hospital Episode Statistics and Office for National Statistics, to estimate sex-specific crude and age-standardised rates of incident ischaemic and non-ischaemic HF up to 10 years per calendar year of diabetes diagnosis and diabetes status.
In a cohort of 735,810 individuals, 5,073 ischaemic (2,038 in people with type 2 diabetes and 3,035 in those without) and 16,501 non-ischaemic (6,358 and 10,143, respectively) HF events were recorded during a median follow-up of 10 years. From 2000 to 2004 to 2005-2009, the age-standardised rates of ischaemic HF marginally declined, while rates remained stable for non-ischaemic HF and were consistently higher for non-ischaemic than ischaemic HF, regardless of diabetes status or sex. Adjusted incidence rate ratios demonstrated negligible impact on trends after accounting for differences in demographics, comorbidities and medications.
Improving HF prevention and management strategies remains crucial to decrease the risk of HF in the general population and reduce the persistent risk-gap associated with type 2 diabetes in England.
调查2000年1月1日至2019年12月31日期间，英格兰患有和未患有2型糖尿病的成年人缺血性和非缺血性心力衰竭（HF）的趋势。
我们使用了临床实践研究数据链数据集，并将其与医院 Episode 统计数据和国家统计局的数据相链接，以估计按性别划分的缺血性和非缺血性HF的粗发病率和年龄标准化发病率，这些发病率是根据糖尿病诊断的每历年和糖尿病状态，最长可达10年。
在一个由735,810人组成的队列中，在中位随访10年期间，记录了5,073例缺血性HF事件（2型糖尿病患者中有2,038例，非2型糖尿病患者中有3,035例）和16,501例非缺血性HF事件（分别为6,358例和10,143例）。从2000年至2004年到2005年至2009年，缺血性HF的年龄标准化发病率略有下降，而非缺血性HF的发病率保持稳定，并且无论糖尿病状态或性别如何，非缺血性HF的发病率始终高于缺血性HF。在考虑了人口统计学、合并症和药物治疗方面的差异后，调整后的发病率比显示对趋势的影响可忽略不计。
改进HF预防和管理策略对于降低普通人群中HF的风险以及减少英格兰与2型糖尿病相关的持续风险差距仍然至关重要。
