Duration and complications of diabetes mellitus and the associated risk of infective endocarditis.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
01 Mar 2019
Historique:
received: 26 05 2018
revised: 14 09 2018
accepted: 25 09 2018
pubmed: 7 10 2018
medline: 23 11 2019
entrez: 7 10 2018
Statut: ppublish

Résumé

Long duration of diabetes mellitus (DM) is associated with an increased risk of infection, however no studies have yet focused on the duration of DM and the associated risk of infective endocarditis (IE). Patients with DM were identified through the Danish Prescription Registry, 1996-2015. Duration of DM was split in follow-up periods of: 0-5 years, 5-10 years, 10-15 years, and >15 years. Multivariable adjusted Poisson regression was used to calculate incidence rate ratios (IRR) according to study groups. DM late-stage complications and the associated risk of IE were investigated as time-varying covariates using the validated Diabetes Complications Severity Index (DCSI). We included 299,551 patients with DM. In patients with DM duration of 0-5 years, 5-10 years, 10-15 years, and >15 years, the incidence rates of IE were 0.24, 0.33, 0.58, and 0.96 cases of IE/1000 person years, respectively. Patients with DM duration 5-10 years, 10-15 years, and >15 years were associated with a higher risk of IE with an IRR of 1.24 (95% CI: 1.02-1.51), 1.92 (95% CI: 1.52-2.43) and 3.05 (95% CI: 2.11-4.40), respectively, compared with DM duration 0-5 years. Patients with a DCSI score of 2, 3 and >3 were associated with a higher risk of IE compared with patients with a DCSI score of 0, IRR = 1.78 (95% CI: 1.34-2.36), IRR = 2.34 (95% CI: 1.73-3.16), and IRR = 2.59 (95% CI: 1.92-3.48), respectively. This study shows a stepwise increase in the risk of IE with DM duration and severity independent of age and known comorbidity.

Sections du résumé

BACKGROUND BACKGROUND
Long duration of diabetes mellitus (DM) is associated with an increased risk of infection, however no studies have yet focused on the duration of DM and the associated risk of infective endocarditis (IE).
METHODS METHODS
Patients with DM were identified through the Danish Prescription Registry, 1996-2015. Duration of DM was split in follow-up periods of: 0-5 years, 5-10 years, 10-15 years, and >15 years. Multivariable adjusted Poisson regression was used to calculate incidence rate ratios (IRR) according to study groups. DM late-stage complications and the associated risk of IE were investigated as time-varying covariates using the validated Diabetes Complications Severity Index (DCSI).
RESULTS RESULTS
We included 299,551 patients with DM. In patients with DM duration of 0-5 years, 5-10 years, 10-15 years, and >15 years, the incidence rates of IE were 0.24, 0.33, 0.58, and 0.96 cases of IE/1000 person years, respectively. Patients with DM duration 5-10 years, 10-15 years, and >15 years were associated with a higher risk of IE with an IRR of 1.24 (95% CI: 1.02-1.51), 1.92 (95% CI: 1.52-2.43) and 3.05 (95% CI: 2.11-4.40), respectively, compared with DM duration 0-5 years. Patients with a DCSI score of 2, 3 and >3 were associated with a higher risk of IE compared with patients with a DCSI score of 0, IRR = 1.78 (95% CI: 1.34-2.36), IRR = 2.34 (95% CI: 1.73-3.16), and IRR = 2.59 (95% CI: 1.92-3.48), respectively.
CONCLUSION CONCLUSIONS
This study shows a stepwise increase in the risk of IE with DM duration and severity independent of age and known comorbidity.

Identifiants

pubmed: 30291010
pii: S0167-5273(18)33424-7
doi: 10.1016/j.ijcard.2018.09.106
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

280-284

Informations de copyright

Copyright © 2018 Elsevier B.V. All rights reserved.

Auteurs

Lauge Østergaard (L)

Heart Centre, Rigshospitalet, Copenhagen, Denmark. Electronic address: laugeoestergaard@gmail.com.

Ulrik M Mogensen (UM)

Zealand University Hospital, Roskilde, Department of Cardiology, Denmark.

Johan S Bundgaard (JS)

Heart Centre, Rigshospitalet, Copenhagen, Denmark.

Anders Dahl (A)

Department of Cardiology, Bispebjerg Hospital, Copenhagen, Denmark.

Andrew Wang (A)

Department of Medicine, Duke University Medical Center, Durham, NC, United States of America.

Christian Torp-Pedersen (C)

Department of Health Science and Technology, Aalborg University, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Denmark.

Gunnar Gislason (G)

Department of Cardiovascular Epidemiology and Research, The Danish Heart Foundation, Copenhagen, Denmark.

Lars Køber (L)

Heart Centre, Rigshospitalet, Copenhagen, Denmark.

Nana Køber (N)

Department of Cardiology, Bispebjerg Hospital, Copenhagen, Denmark.

Thomas Fremming Dejgaard (TF)

Steno Diabetes Center Copenhagen, Copenhagen, Denmark.

Christian Seerup Frandsen (CS)

The Juliane Marie Center, Rigshospitalet, Copenhagen, Denmark.

Emil Loldrup Fosbøl (EL)

Heart Centre, Rigshospitalet, Copenhagen, Denmark.

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