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Bibliographic Details
Main Authors: Asger Ahlmann Bech, Mia Daugaard Madsen, Annika Vestergaard Kvist, Peter Vestergaard, Nicklas Højgaard‐hessellund Rasmussen
Format: Artículo Open Access
Published: Wiley 2025
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Online Access:https://onlinelibrary.wiley.com/doi/10.1111/1753-0407.70076
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  • Diabetes Complications and Comorbidities as Risk Factors for MACE in People With Type 2 Diabetes and Their Development Over Time: A Danish Registry‐Based Case–Control Study Asger Ahlmann Bech Mia Daugaard Madsen Annika Vestergaard Kvist Peter Vestergaard Nicklas Højgaard‐hessellund Rasmussen Journal of Diabetes ABSTRACTAimThis study aimed to investigate the association between cardiovascular risk factors and major adverse cardiovascular events (MACE) in people with type 2 diabetes, while assessing potential changes over time.MethodsUtilizing data from Danish registries, this study identified people with type 2 diabetes between 2002 and 2021 (n = 372 328) and subdivided them into two 10‐year time periods: TP1: 2002–2011 and TP2: 2012–2021, and further categorized into cases and controls. Cases were defined as having suffered a first‐time three‐point MACE (nTP1 = 12 713, nTP2 = 8981) and matched 1:1 with controls on age, sex, and type 2 diabetes duration. Exposures were preselected diabetes complications and comorbidities.ResultsFewer were affected by MACE during TP2 compared to TP1 (p < 0.001). Diabetes complications associated with MACE were nephropathy (ORTP1 = 1.54, 95% CI 1.30–1.83, ORTP2 = 1.47, 95% CI 1.20–1.79), neuropathy (ORTP1 = 2.02, 95% CI 1.84–2.21 ORTP2 = 1.58, 95% CI 1.44–1.73) and retinopathy (ORTP1 = 1.10, 95% CI 0.98–1.23, ORTP2 = 1.38, 95% CI 1.17–1.63). Comorbidities associated with MACE included hypertension (ORTP1 = 1.30, 95% CI 1.22–1.38 ORTP2 = 1.31, 95% CI 1.22–1.41), atrial flutter or fibrillation (ORTP1 = 1.46, 95% CI 1.35–1.58, ORTP2 = 1.37, 95% CI 1.26–1.50), heart failure (ORTP1 = 1.53, 95% CI 1.401.67‐, ORTP2 = 1.37, 95% CI 1.23–1.54) and hypercholesterolemia (ORTP1 = 1.13, 95% CI 1.07–1.20, ORTP2 = 1.02, 95% CI 0.96–1.10). Hypercholesterolemia (p = 0.038) and neuropathy (p = 0.038) exhibited a significant decrease in association with MACE between the time periods.ConclusionsThe prevalence of first‐time MACE decreased over time, despite a relatively stable prevalence of type 2 diabetes. Several diabetes‐related complications and comorbidities were significantly associated with MACE. The associations of neuropathy and hypercholesterolemia with MACE lessened over time, suggesting potential improvements in risk management or treatment strategies. 10.1111/1753-0407.70076 http://creativecommons.org/licenses/by/4.0/