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Socioeconomic position and first-time major cardiovascular event in patients with type 2 diabetes: a Danish nationwide cohort study

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Falkentoft, Alexander C ; Zareini, Bochra ; Andersen, Julie ; Wichmand, Charlotte ; Hansen, Tina B ; Selmer, Christian ; Schou, Morten ; Gæde, Peter Haulund ; Staehr, Peter Bisgaard ; Hlatky, Mark A ; Torp-Pedersen, Christian ; Gislason, Gunnar H ; Gerds, Thomas Alexander ; Bruun, Niels E ; Ruwald, Anne-Christine. / Socioeconomic position and first-time major cardiovascular event in patients with type 2 diabetes : a Danish nationwide cohort study. In: European Journal of Preventive Cardiology. 2021 ; Vol. 28, No. 16. pp. 1819-1828.

Bibtex

@article{fd2c3cdadd324ba7a13ed1226938af02,
title = "Socioeconomic position and first-time major cardiovascular event in patients with type 2 diabetes: a Danish nationwide cohort study",
abstract = "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.",
author = "Falkentoft, {Alexander C} and Bochra Zareini and Julie Andersen and Charlotte Wichmand and Hansen, {Tina B} and Christian Selmer and Morten Schou and G{\ae}de, {Peter Haulund} and Staehr, {Peter Bisgaard} and Hlatky, {Mark A} and Christian Torp-Pedersen and Gislason, {Gunnar H} and Gerds, {Thomas Alexander} and Bruun, {Niels E} and Anne-Christine Ruwald",
note = "Published on behalf of the European Society of Cardiology. All rights reserved. {\textcopyright} The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.",
year = "2021",
month = dec,
doi = "10.1093/eurjpc/zwab065",
language = "English",
volume = "28",
pages = "1819--1828",
journal = "European Journal of Preventive Cardiology",
issn = "2047-4873",
publisher = "Sage Publications Ltd",
number = "16",

}

RIS

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: journals.permissions@oup.com.

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.

U2 - 10.1093/eurjpc/zwab065

DO - 10.1093/eurjpc/zwab065

M3 - Journal article

C2 - 34037228

VL - 28

SP - 1819

EP - 1828

JO - European Journal of Preventive Cardiology

JF - European Journal of Preventive Cardiology

SN - 2047-4873

IS - 16

M1 - zwab065

ER -

ID: 68136139