Risk of a Recurrent Cardiovascular Event in Individuals With Type 2 Diabetes or Intermediate Hyperglycemia. The Hoorn Study

Amber A. W. A. van der Heijden*, Esther van't Riet, Sandra D. M. Bot, Suzanne C. Cannegieter, Coen D. A. Stehouwer, C.A. Baan, Jacqueline M. Dekker, Giel Nijpels

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

OBJECTIVETo investigate risk of a recurrent cardiovascular event and its predictors in a population-based cohort.RESEARCH DESIGN AND METHODSParticipants of the Hoorn Study who had experienced a first cardiovascular event after baseline (n = 336) were followed with respect to a recurrent event. Absolute risk of a recurrent event was calculated for individuals with normal glucose metabolism, intermediate hyperglycemia, and type 2 diabetes. Cox regression models were used to investigate which variables, measured before the first vascular event, predicted a recurrent event using the stepwise backward procedure.RESULTSDuring a median follow-up of 4.1 years, 44% (n = 148) of the population developed a recurrent vascular event. The rate of recurrent events per 100 person-years was 7.2 (95% CI 5.8-8.7) in individuals with normal glucose metabolism, compared with 9.8 (6.6-14.0) in individuals with intermediate hyperglycemia and 12.5 (8.5-17.6) in individuals with type 2 diabetes. Higher age (hazard ratio 1.02 [95% CI 1.00-1.04]), male sex (1.56 [1.08-2.25]), waist circumference (1.02 [1.02-1.03]), higher systolic blood pressure (1.01 [1.01-1.02]), higher HbA(1c) (%, 1.13 [0.97-1.31]/ mmol/mol, 1.01 [1.00-1.03]), and family history of myocardial infarction (1.38 [0.96-2.00]) predicted a recurrent cardiovascular event.CONCLUSIONSIndividuals with type 2 diabetes, but not individuals with intermediate hyperglycemia, are at increased risk for a recurrent vascular event compared with individuals with normal glucose metabolism. In people with a history of cardiovascular disease, people at increased risk of a recurrent event can be identified based on the patient's risk profile before the first event.

Original languageEnglish
Pages (from-to)3498-3502
Number of pages5
JournalDiabetes Care: The Journal of Clinical and Applied Research and Education
Volume36
Issue number11
DOIs
Publication statusPublished - Nov 2013
Externally publishedYes

Keywords

  • CORONARY-HEART-DISEASE
  • CAUCASIAN POPULATION
  • PREVALENCE
  • MORTALITY
  • GLUCOSE
  • PARADOX
  • INDEX

Cite this

van der Heijden, Amber A. W. A. ; van't Riet, Esther ; Bot, Sandra D. M. ; Cannegieter, Suzanne C. ; Stehouwer, Coen D. A. ; Baan, C.A. ; Dekker, Jacqueline M. ; Nijpels, Giel. / Risk of a Recurrent Cardiovascular Event in Individuals With Type 2 Diabetes or Intermediate Hyperglycemia. The Hoorn Study. In: Diabetes Care: The Journal of Clinical and Applied Research and Education. 2013 ; Vol. 36, No. 11. pp. 3498-3502.
@article{a26800f6378641ac9503e9437332fbd2,
title = "Risk of a Recurrent Cardiovascular Event in Individuals With Type 2 Diabetes or Intermediate Hyperglycemia. The Hoorn Study",
abstract = "OBJECTIVETo investigate risk of a recurrent cardiovascular event and its predictors in a population-based cohort.RESEARCH DESIGN AND METHODSParticipants of the Hoorn Study who had experienced a first cardiovascular event after baseline (n = 336) were followed with respect to a recurrent event. Absolute risk of a recurrent event was calculated for individuals with normal glucose metabolism, intermediate hyperglycemia, and type 2 diabetes. Cox regression models were used to investigate which variables, measured before the first vascular event, predicted a recurrent event using the stepwise backward procedure.RESULTSDuring a median follow-up of 4.1 years, 44{\%} (n = 148) of the population developed a recurrent vascular event. The rate of recurrent events per 100 person-years was 7.2 (95{\%} CI 5.8-8.7) in individuals with normal glucose metabolism, compared with 9.8 (6.6-14.0) in individuals with intermediate hyperglycemia and 12.5 (8.5-17.6) in individuals with type 2 diabetes. Higher age (hazard ratio 1.02 [95{\%} CI 1.00-1.04]), male sex (1.56 [1.08-2.25]), waist circumference (1.02 [1.02-1.03]), higher systolic blood pressure (1.01 [1.01-1.02]), higher HbA(1c) ({\%}, 1.13 [0.97-1.31]/ mmol/mol, 1.01 [1.00-1.03]), and family history of myocardial infarction (1.38 [0.96-2.00]) predicted a recurrent cardiovascular event.CONCLUSIONSIndividuals with type 2 diabetes, but not individuals with intermediate hyperglycemia, are at increased risk for a recurrent vascular event compared with individuals with normal glucose metabolism. In people with a history of cardiovascular disease, people at increased risk of a recurrent event can be identified based on the patient's risk profile before the first event.",
keywords = "CORONARY-HEART-DISEASE, CAUCASIAN POPULATION, PREVALENCE, MORTALITY, GLUCOSE, PARADOX, INDEX",
author = "{van der Heijden}, {Amber A. W. A.} and {van't Riet}, Esther and Bot, {Sandra D. M.} and Cannegieter, {Suzanne C.} and Stehouwer, {Coen D. A.} and C.A. Baan and Dekker, {Jacqueline M.} and Giel Nijpels",
year = "2013",
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language = "English",
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pages = "3498--3502",
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Risk of a Recurrent Cardiovascular Event in Individuals With Type 2 Diabetes or Intermediate Hyperglycemia. The Hoorn Study. / van der Heijden, Amber A. W. A.; van't Riet, Esther; Bot, Sandra D. M.; Cannegieter, Suzanne C.; Stehouwer, Coen D. A.; Baan, C.A.; Dekker, Jacqueline M.; Nijpels, Giel.

In: Diabetes Care: The Journal of Clinical and Applied Research and Education, Vol. 36, No. 11, 11.2013, p. 3498-3502.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Risk of a Recurrent Cardiovascular Event in Individuals With Type 2 Diabetes or Intermediate Hyperglycemia. The Hoorn Study

AU - van der Heijden, Amber A. W. A.

AU - van't Riet, Esther

AU - Bot, Sandra D. M.

AU - Cannegieter, Suzanne C.

AU - Stehouwer, Coen D. A.

AU - Baan, C.A.

AU - Dekker, Jacqueline M.

AU - Nijpels, Giel

PY - 2013/11

Y1 - 2013/11

N2 - OBJECTIVETo investigate risk of a recurrent cardiovascular event and its predictors in a population-based cohort.RESEARCH DESIGN AND METHODSParticipants of the Hoorn Study who had experienced a first cardiovascular event after baseline (n = 336) were followed with respect to a recurrent event. Absolute risk of a recurrent event was calculated for individuals with normal glucose metabolism, intermediate hyperglycemia, and type 2 diabetes. Cox regression models were used to investigate which variables, measured before the first vascular event, predicted a recurrent event using the stepwise backward procedure.RESULTSDuring a median follow-up of 4.1 years, 44% (n = 148) of the population developed a recurrent vascular event. The rate of recurrent events per 100 person-years was 7.2 (95% CI 5.8-8.7) in individuals with normal glucose metabolism, compared with 9.8 (6.6-14.0) in individuals with intermediate hyperglycemia and 12.5 (8.5-17.6) in individuals with type 2 diabetes. Higher age (hazard ratio 1.02 [95% CI 1.00-1.04]), male sex (1.56 [1.08-2.25]), waist circumference (1.02 [1.02-1.03]), higher systolic blood pressure (1.01 [1.01-1.02]), higher HbA(1c) (%, 1.13 [0.97-1.31]/ mmol/mol, 1.01 [1.00-1.03]), and family history of myocardial infarction (1.38 [0.96-2.00]) predicted a recurrent cardiovascular event.CONCLUSIONSIndividuals with type 2 diabetes, but not individuals with intermediate hyperglycemia, are at increased risk for a recurrent vascular event compared with individuals with normal glucose metabolism. In people with a history of cardiovascular disease, people at increased risk of a recurrent event can be identified based on the patient's risk profile before the first event.

AB - OBJECTIVETo investigate risk of a recurrent cardiovascular event and its predictors in a population-based cohort.RESEARCH DESIGN AND METHODSParticipants of the Hoorn Study who had experienced a first cardiovascular event after baseline (n = 336) were followed with respect to a recurrent event. Absolute risk of a recurrent event was calculated for individuals with normal glucose metabolism, intermediate hyperglycemia, and type 2 diabetes. Cox regression models were used to investigate which variables, measured before the first vascular event, predicted a recurrent event using the stepwise backward procedure.RESULTSDuring a median follow-up of 4.1 years, 44% (n = 148) of the population developed a recurrent vascular event. The rate of recurrent events per 100 person-years was 7.2 (95% CI 5.8-8.7) in individuals with normal glucose metabolism, compared with 9.8 (6.6-14.0) in individuals with intermediate hyperglycemia and 12.5 (8.5-17.6) in individuals with type 2 diabetes. Higher age (hazard ratio 1.02 [95% CI 1.00-1.04]), male sex (1.56 [1.08-2.25]), waist circumference (1.02 [1.02-1.03]), higher systolic blood pressure (1.01 [1.01-1.02]), higher HbA(1c) (%, 1.13 [0.97-1.31]/ mmol/mol, 1.01 [1.00-1.03]), and family history of myocardial infarction (1.38 [0.96-2.00]) predicted a recurrent cardiovascular event.CONCLUSIONSIndividuals with type 2 diabetes, but not individuals with intermediate hyperglycemia, are at increased risk for a recurrent vascular event compared with individuals with normal glucose metabolism. In people with a history of cardiovascular disease, people at increased risk of a recurrent event can be identified based on the patient's risk profile before the first event.

KW - CORONARY-HEART-DISEASE

KW - CAUCASIAN POPULATION

KW - PREVALENCE

KW - MORTALITY

KW - GLUCOSE

KW - PARADOX

KW - INDEX

U2 - 10.2337/dc12-2691

DO - 10.2337/dc12-2691

M3 - Article

VL - 36

SP - 3498

EP - 3502

JO - Diabetes Care: The Journal of Clinical and Applied Research and Education

JF - Diabetes Care: The Journal of Clinical and Applied Research and Education

SN - 0149-5992

IS - 11

ER -