TY - JOUR
T1 - Socioeconomic position and first-time major cardiovascular event in patients with type 2 diabetes
T2 - a Danish nationwide cohort study
AU - Falkentoft, Alexander C
AU - Zareini, Bochra
AU - Andersen, Julie
AU - Wichmand, Charlotte
AU - Hansen, Tina B
AU - Selmer, Christian
AU - Schou, Morten
AU - Gæde, Peter Haulund
AU - Staehr, Peter Bisgaard
AU - Hlatky, Mark A
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar H
AU - Gerds, Thomas Alexander
AU - Bruun, Niels E
AU - Ruwald, Anne-Christine
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: [email protected].
PY - 2021/12
Y1 - 2021/12
N2 - AIMS : The association between socioeconomic position and cardiovascular disease has not been well studied in patients with type 2 diabetes. We aimed to examine the association between socioeconomic position and first-time major adverse cardiovascular events (MACE) in patients with type 2 diabetes.METHODS AND RESULTS : Through the Danish nationwide registers, we identified all residents with newly diagnosed type 2 diabetes between 2012 and 2017. Based on sex-stratified multivariable cause-specific Cox regression models, we calculated the standardized absolute 5-year risk of the composite outcome of first-time myocardial infarction, stroke, or cardiovascular mortality (MACE) according to income quartiles. A total of 57 106 patients with type 2 diabetes were included. During 155 989 person years, first-time MACE occurred in 2139 patients. Among both men and women, income was inversely associated with the standardized absolute 5-year risk of MACE. In men, the 5-year risk of MACE increased from 5.7% [95% confidence interval (CI) 4.9-6.5] in the highest income quartile to 9.3% (CI 8.3-10.2) in the lowest income group, with a risk difference of 3.5% (CI 2.4-4.7). In women, the risk of MACE increased from 4.2% (CI 3.4-5.0) to 6.1% (CI 5.2-7.0) according to income level, with a risk difference of 1.9% (CI 0.8-2.9).CONCLUSION : Despite free access to medical care in Denmark, low-socioeconomic position was associated with a higher 5-year risk of first-time MACE in patients with incident type 2 diabetes. Our results suggest prevention strategies could be developed specifically for patients with low-socioeconomic position.
AB - AIMS : The association between socioeconomic position and cardiovascular disease has not been well studied in patients with type 2 diabetes. We aimed to examine the association between socioeconomic position and first-time major adverse cardiovascular events (MACE) in patients with type 2 diabetes.METHODS AND RESULTS : Through the Danish nationwide registers, we identified all residents with newly diagnosed type 2 diabetes between 2012 and 2017. Based on sex-stratified multivariable cause-specific Cox regression models, we calculated the standardized absolute 5-year risk of the composite outcome of first-time myocardial infarction, stroke, or cardiovascular mortality (MACE) according to income quartiles. A total of 57 106 patients with type 2 diabetes were included. During 155 989 person years, first-time MACE occurred in 2139 patients. Among both men and women, income was inversely associated with the standardized absolute 5-year risk of MACE. In men, the 5-year risk of MACE increased from 5.7% [95% confidence interval (CI) 4.9-6.5] in the highest income quartile to 9.3% (CI 8.3-10.2) in the lowest income group, with a risk difference of 3.5% (CI 2.4-4.7). In women, the risk of MACE increased from 4.2% (CI 3.4-5.0) to 6.1% (CI 5.2-7.0) according to income level, with a risk difference of 1.9% (CI 0.8-2.9).CONCLUSION : Despite free access to medical care in Denmark, low-socioeconomic position was associated with a higher 5-year risk of first-time MACE in patients with incident type 2 diabetes. Our results suggest prevention strategies could be developed specifically for patients with low-socioeconomic position.
UR - http://www.scopus.com/inward/record.url?scp=85123646297&partnerID=8YFLogxK
U2 - 10.1093/eurjpc/zwab065
DO - 10.1093/eurjpc/zwab065
M3 - Journal article
C2 - 34037228
SN - 2047-4873
VL - 28
SP - 1819
EP - 1828
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 16
M1 - zwab065
ER -