Diabetic retinopathy predicts cardiovascular disease independently of subclinical atherosclerosis in individuals with type 2 diabetes : A prospective cohort study
Castelblanco, Esmeralda (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Granado-Casas, Minerva (Institut d'Investigació Biomèdica Sant Pau)
Hernández García, Marta (Hospital Universitari Arnau de Vilanova)
Pinyol, Montserrat (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Correig Fraga, Eudald (Universitat Rovira i Virgili. Departament de Ciències Mèdiques Bàsiques)
Julve i Gil, Josep (Institut d'Investigació Biomèdica Sant Pau)
Rojo-López, Marina Idalia (Institut d'Investigació Biomèdica Sant Pau)
Alonso Pedrol, Núria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Avogaro, Angelo (Department of Medicine, Università di Padova)
Ortega, Emilio (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Mauricio Puente, Dídac (Universitat de Vic - Universitat Central de Catalunya)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Diabetic retinopathy (DR) and preclinical atherosclerosis are associated with higher cardiovascular risk. However, no studies have investigated the predictive role of DR and preclinical atherosclerosis jointly on cardiovascular events in subjects with type 2 diabetes (T2D). We aimed to assess the contribution of DR and subclinical atherosclerosis on the risk of adverse cardiovascular events in subjects with T2D without previous cardiovascular disease (CVD). We included two prospective cohorts of subjects with T2D from the same geographical area. Assessment of subclinical atherosclerosis was performed by carotid ultrasound. An ophthalmologist classified DR according to standard criteria. Cardiovascular outcomes considered for analysis were the following: ischemic heart disease, stroke, heart failure, peripheral artery disease, revascularization procedures, and cardiovascular mortality. Bivariable and multivariable predictive models were performed. From a total of 374 subjects with T2D 44 developed cardiovascular events during the 7. 1 years of follow-up. Diabetes duration, total cholesterol, and glycated hemoglobin (HbA1c) at baseline were higher in subjects who developed cardiovascular outcomes (p < 0. 001, p = 0. 026, and p = 0. 040, respectively). Compared with subjects without events, those developing cardiovascular events had higher prevalence of retinopathy (65. 9% vs. 38. 8%, p = 0. 001; respectively) and more than mild retinopathy (43. 2% vs. 31. 8%, p = 0. 002; respectively). Furthermore, all-cause mortality was higher in subjects with MACE than those without events (13. 6% vs. 3. 3%, p = 0. 009; respectively). The multivariable analyses showed that HbA1c and the presence of DR at baseline were predictive of cardiovascular outcomes (p = 0. 045 and p = 0. 023, respectively). However, the burden of subclinical atherosclerosis was not (p = 0. 783 and p = 0. 071, respectively). DR is a strong predictor of cardiovascular events in T2D individuals at primary CVD prevention, even after accounting for the presence of preclinical carotid atherosclerosis. These results may help to individualize CVD prevention strategies in T2D.
Ajuts:	Instituto de Salud Carlos III PS09/01035 Instituto de Salud Carlos III PI11/01723
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Type 2 diabetes ; Diabetic retinopathy ; Subclinical atherosclerosis ; Cardiovascular disease ; Major adverse cardiovascular events
Publicat a:	Frontiers in Cardiovascular Medicine, Vol. 9 (november 2022) , ISSN 2297-055X

DOI: 10.3389/fcvm.2022.945421
PMID: 36407461

11 p, 1.0 MB

El registre apareix a les col·leccions:
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut de Recerca Sant Pau
Articles > Articles de recerca
Articles > Articles publicats