Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Retinopathy, Neuropathy, and Subsequent Cardiovascular Events in Patients with Type 2 Diabetes and Acute Coronary Syndrome in the ELIXA: The Importance of Disease Duration

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Reproducibility of Glucose Fluctuations Induced by Moderate Intensity Cycling Exercise in Persons with Type 1 Diabetes

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Insulin Treatment Attenuates Small Nerve Fiber Damage in Rat Model of Type 2 Diabetes

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Healing of Diabetic Foot Ulcers in Patients Treated at the Copenhagen Wound Healing Center in 1999/2000 and in 2011/2012

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Diabetes Is Associated with Musculoskeletal Pain, Osteoarthritis, Osteoporosis, and Rheumatoid Arthritis

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Oral LPS Dosing Induces Local Immunological Changes in the Pancreatic Lymph Nodes in Mice

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Outcome of dialysis-requiring acute kidney injury in patients with infective endocarditis: A nationwide study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Prognosis of myocardial infarction-related cardiogenic shock according to preadmission out-of-hospital cardiac arrest

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Time to Thrombolysis and Long-Term Outcomes in Patients With Acute Ischemic Stroke: A Nationwide Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Jelena P Seferovic
  • Rhonda Bentley-Lewis
  • Brian Claggett
  • Rafael Diaz
  • Hertzel C Gerstein
  • Lars V Køber
  • Francesca C Lawson
  • Eldrin F Lewis
  • Aldo P Maggioni
  • John J V McMurray
  • Jeffrey L Probstfield
  • Matthew C Riddle
  • Scott D Solomon
  • Jean-Claude Tardif
  • Marc A Pfeffer
View graph of relations

Introduction: We investigated the association of diabetic retinopathy and neuropathy with increased risk of recurrent cardiovascular (CV) events in 6068 patients with type 2 diabetes mellitus (T2DM) and recent acute coronary syndrome (ACS) enrolled in the Evaluation of Lixisenatide in Acute Coronary Syndrome (ELIXA).

Methods: History of retinopathy and neuropathy as well as duration of T2DM were self-reported at screening. Proportional hazards regression models were used to assess relationships between retinopathy, neuropathy, and recurrent CV events.

Results: At screening, retinopathy and neuropathy were reported in 10.7% and 17.5% of patients, respectively, while 5.7% reported both. When adjusted for randomized treatment only, both retinopathy and neuropathy were associated with a primary composite outcome (CV death, nonfatal MI, stroke, or hospitalization for unstable angina) (retinopathy: HR 1.44, 95% CI 1.19-1.75; neuropathy: HR 1.33, 95% CI 1.12-1.57), CV composite (CV death, nonfatal MI, stroke, hospitalization for heart failure (HF)) (retinopathy: HR 1.57, 95% CI 1.31-1.88; neuropathy: HR 1.38, 95% CI 1.19-1.62), myocardial infarction (retinopathy: HR 1.38, 95% CI 1.08-1.76; neuropathy: HR 1.26, 95% CI 1.02-1.54), HF hospitalization (retinopathy: HR 2.03, 95% CI 1.48-2.78; neuropathy: HR 1.71, 95% CI 1.30-2.27), and all-cause mortality (retinopathy: HR 1.65, 95% CI 1.28-2.12; neuropathy: HR 1.43, 95% CI 1.14-1.78). When included in the same model, and adjusted for T2DM duration, there were no independent associations of either with CV outcomes, while T2DM duration remained strongly associated with all outcomes. Addition of demographic characteristics and CV risk factors did not further alter these relationships.

Conclusions: In patients with T2DM and recent ACS, a history of retinopathy and/or neuropathy and longer T2DM duration could be considered clinical markers for high risk of recurrent CV events. This trial is registered with the ELIXA (Evaluation of Lixisenatide in Acute Coronary Syndrome), ClinicalTrials.gov registration number NCT01147250.

Original languageEnglish
JournalJournal of Diabetes Research
Volume2018
Pages (from-to)1631263
ISSN2314-6745
DOIs
Publication statusPublished - 1 Jan 2018

    Research areas

  • Acute Coronary Syndrome/complications, Aged, Cardiovascular Diseases/complications, Diabetes Mellitus, Type 2/complications, Diabetic Neuropathies/complications, Diabetic Retinopathy/complications, Female, Humans, Male, Middle Aged, Peptides/therapeutic use, Risk Factors

ID: 58229208