TY - JOUR
T1 - Duration and complications of diabetes mellitus and the associated risk of infective endocarditis
AU - Østergaard, Lauge
AU - Mogensen, Ulrik M
AU - Bundgaard, Johan S
AU - Dahl, Anders
AU - Wang, Andrew
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar
AU - Køber, Lars
AU - Køber, Nana
AU - Dejgaard, Thomas Fremming
AU - Frandsen, Christian Seerup
AU - Fosbøl, Emil Loldrup
N1 - Copyright © 2018 Elsevier B.V. All rights reserved.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - BACKGROUND: Long duration of diabetes mellitus (DM) is associated with an increased risk of infection, however no studies have yet focused on the duration of DM and the associated risk of infective endocarditis (IE).METHODS: Patients with DM were identified through the Danish Prescription Registry, 1996-2015. Duration of DM was split in follow-up periods of: 0-5 years, 5-10 years, 10-15 years, and >15 years. Multivariable adjusted Poisson regression was used to calculate incidence rate ratios (IRR) according to study groups. DM late-stage complications and the associated risk of IE were investigated as time-varying covariates using the validated Diabetes Complications Severity Index (DCSI).RESULTS: We included 299,551 patients with DM. In patients with DM duration of 0-5 years, 5-10 years, 10-15 years, and >15 years, the incidence rates of IE were 0.24, 0.33, 0.58, and 0.96 cases of IE/1000 person years, respectively. Patients with DM duration 5-10 years, 10-15 years, and >15 years were associated with a higher risk of IE with an IRR of 1.24 (95% CI: 1.02-1.51), 1.92 (95% CI: 1.52-2.43) and 3.05 (95% CI: 2.11-4.40), respectively, compared with DM duration 0-5 years. Patients with a DCSI score of 2, 3 and >3 were associated with a higher risk of IE compared with patients with a DCSI score of 0, IRR = 1.78 (95% CI: 1.34-2.36), IRR = 2.34 (95% CI: 1.73-3.16), and IRR = 2.59 (95% CI: 1.92-3.48), respectively.CONCLUSION: This study shows a stepwise increase in the risk of IE with DM duration and severity independent of age and known comorbidity.
AB - BACKGROUND: Long duration of diabetes mellitus (DM) is associated with an increased risk of infection, however no studies have yet focused on the duration of DM and the associated risk of infective endocarditis (IE).METHODS: Patients with DM were identified through the Danish Prescription Registry, 1996-2015. Duration of DM was split in follow-up periods of: 0-5 years, 5-10 years, 10-15 years, and >15 years. Multivariable adjusted Poisson regression was used to calculate incidence rate ratios (IRR) according to study groups. DM late-stage complications and the associated risk of IE were investigated as time-varying covariates using the validated Diabetes Complications Severity Index (DCSI).RESULTS: We included 299,551 patients with DM. In patients with DM duration of 0-5 years, 5-10 years, 10-15 years, and >15 years, the incidence rates of IE were 0.24, 0.33, 0.58, and 0.96 cases of IE/1000 person years, respectively. Patients with DM duration 5-10 years, 10-15 years, and >15 years were associated with a higher risk of IE with an IRR of 1.24 (95% CI: 1.02-1.51), 1.92 (95% CI: 1.52-2.43) and 3.05 (95% CI: 2.11-4.40), respectively, compared with DM duration 0-5 years. Patients with a DCSI score of 2, 3 and >3 were associated with a higher risk of IE compared with patients with a DCSI score of 0, IRR = 1.78 (95% CI: 1.34-2.36), IRR = 2.34 (95% CI: 1.73-3.16), and IRR = 2.59 (95% CI: 1.92-3.48), respectively.CONCLUSION: This study shows a stepwise increase in the risk of IE with DM duration and severity independent of age and known comorbidity.
KW - Diabetes late-stage complications
KW - Diabetes mellitus
KW - Infective endocarditis
U2 - 10.1016/j.ijcard.2018.09.106
DO - 10.1016/j.ijcard.2018.09.106
M3 - Journal article
C2 - 30291010
SN - 0167-5273
VL - 278
SP - 280
EP - 284
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -