Diabetes, obesity & metabolism

Heart failure, chronic kidney disease, and death risk in type 2 diabetes: Findings from a large international study

Updated

Abstract

Of 1,177,896 patients with type 2 diabetes, 772,336 (66%) were free from cardiovascular or renal disease (CVRD) at the start of the study.

  • Over a mean follow-up of 4.5 years, 137,081 patients (18%) developed their first manifestation of CVRD.
  • The most common initial manifestations were chronic kidney disease (36%), heart failure (24%), stroke (16%), myocardial infarction (14%), and peripheral artery disease (10%).
  • Heart failure and chronic kidney disease were linked to significantly higher risks of cardiovascular and all-cause mortality.
  • The hazard ratios for heart failure and chronic kidney disease were 2.02 and 2.05, respectively, indicating more than double the risk compared to those free of CVRD.
  • The combination of heart failure and chronic kidney disease presented the highest mortality risks, with hazard ratios of 3.91 and 3.14 for cardiovascular and all-cause mortality, respectively.

Simplified

Key numbers

2.02
Increase in Mortality Risk (Heart Failure)
Hazard ratio for all-cause mortality in patients with heart failure vs. CVRD-free status.
2.05
Increase in Mortality Risk (Chronic Kidney Disease)
Hazard ratio for cardiovascular mortality in patients with chronic kidney disease vs. CVRD-free status.
137081 of 772336
Prevalence of Cardiorenal Disease Manifestation
Number of patients developing first CVRD manifestation out of those initially CVRD-free.

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Funding

Competing interests

K.I.B. has received grants to his institution from AstraZeneca for this study and for lectures and consulting from Novo Nordisk, Sanofi, Lilly, Boehringer Ingelheim and Merck Sharp & Dohme. J.B. holds a full‐time position at AstraZeneca as an epidemiologist. J.W.E. has received honoraria or research grants from AstraZeneca, NovoNordisk, Bayer, Sanofi and MSD. A.N. has received honoraria from MSD, Astra Zeneca, Eli Lilly, Boehringer Ingelheim and Novo Nordisk. H.H has received lecture fees and travel expenses from Alexion, Baxter, NovoNordisk, Noxxon, Janssen and AstraZeneca. G.C.M.L. has no competing interests. M.T. is employed by an independent statistical consultant company, Statisticon AB, Uppsala, Sweden, of which AstraZeneca Nordic‐Baltic is a client. S.O. is a full‐time employee of AstraZeneca. E.G.P. is an employee of Team Gesundheit GmbH and conducted work on behalf of Kantar Health. J.O. is an employee of the PHARMO Institute for Drug Outcomes Research, an independent research institute that performs financially supported studies for government and related healthcare authorities and for several pharmaceutical companies. R.Z. and T.Y. are full‐time employees of AstraZeneca. I.K. declares grants from Astellas Pharma Inc., Boehringer Ingelheim Japan, Kowa Pharmaceutical Co. Ltd, Daiichi Sankyo Co. Ltd, Mitsubishi Tanabe Pharma Corp., Shionogi & Co., Ltd, Sumitomo Dainippon Pharma Co., Ltd, Pfizer Japan Inc., Takeda Pharmaceutical Co. Ltd, Toa Eiyo Ltd, honoraria from Astellas Pharma Inc., Boehringer Ingelheim Japan, Kowa Pharmaceutical Co. Ltd, Daiichi Sankyo Co. Ltd, Mitsubishi Tanabe Pharma Corp., Shionogi & Co., Ltd, Sumitomo Dainippon Pharma Co., Ltd, Pfizer Japan Inc., Takeda Pharmaceutical Co. Ltd and Toa Eiyo Ltd, and lecture/other fees from AstraZeneca. T.K. declares grants from Asahi Mutual Life Insurance Co., Boehringer Ingelheim Japan, Daiichi Sankyo Co. Ltd, Kowa Pharmaceutical Co. Ltd, Mitsubishi Tanabe Pharma Corp., MSD K.K., Novo Nordisk Pharma Ltd, Sanofi K.K. and Takeda Pharmaceutical Co. Ltd and lecture/other fees from AstraZeneca K.K., Astellas Pharma Inc., Boehringer Ingelheim Japan, Daiichi Sankyo Co. Ltd, Eli Lilly Japan K.K., Kowa Pharmaceutical Co. Ltd, Kyowa Hakko Kirin Co., Ltd, Mitsubishi Tanabe Pharma Corp., MSD K.K., Ono Pharmaceutical Co. Ltd, Sanofi K.K., Sumitomo Dainippon Pharma Co., Ltd, Sanwa Kagaku Kenkyusho Co. Ltd, Taisho Pharmaceutical Co., Ltd and Takeda Pharmaceutical Co, Ltd.
PubMed

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