Information de reference pour ce titreAccession Number: | 00003441-201208000-00005.
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Author: | Saleh, N. 1; Petursson, P. 2; Lagerqvist, B. 3; Skuladottir, H. 1; Svensson, A. 4; Eliasson, B. 5; Gudbjornsdottir, S. 5; Eeg-Olofsson, K. 5; Norhammar, A. 1
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Institution: | (1)Cardiology Unit, Department of Medicine, Karolinska University Hospital, N3:06, Solna, 171 76 Stockholm, Sweden (2)Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (3)Department of Medical Sciences, Uppsala University, Uppsala, Sweden (4)Centre of Registers in Region Vastra Gotaland, Gothenburg, Sweden (5)Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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Title: | Long-term mortality in patients with type 2 diabetes undergoing coronary angiography: the impact of glucose-lowering treatment.[Article]
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Source: | Diabetologia. 55(8):2109-2117, August 2012.
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Abstract: | Aims/hypothesis: The aim of this study was to analyse whether the increased mortality rates observed in insulin-treated patients with type 2 diabetes and coronary artery disease are explained by comorbidities and complications.
Methods: A retrospective analysis of data from two Swedish registries of type 2 diabetic patients (n = 12,515) undergoing coronary angiography between the years 2001 and 2009 was conducted. The association between glucose-lowering treatment and long-term mortality was studied after extensive adjustment for cardiovascular- and diabetes-related confounders. Patients were classified into four groups, according to glucose-lowering treatment: diet alone; oral therapy alone; insulin in combination with oral therapy; and insulin alone.
Results: After a mean follow-up time of 4.14 years, absolute mortality rates for patients treated with diet alone, oral therapy alone, insulin in combination with oral therapy and insulin alone were 19.2%, 17.4%, 22.9% and 28.1%, respectively. Compared with diet alone, insulin in combination with oral therapy (HR 1.27; 95% CI 1.12, 1.43) and insulin alone (HR 1.62; 95% CI 1.44, 1.83) were associated with higher mortality rates. After adjustment for baseline differences, insulin in combination with oral glucose-lowering treatment (HR 1.22; 95% CI 1.06, 1.40; p < 0.005) and treatment with insulin only (HR 1.17; 95% CI 1.02, 1.35; p < 0.01) remained independent predictors for long-term mortality.
Conclusions/interpretation: Type 2 diabetes patients treated with insulin and undergoing coronary angiography have a higher long-term mortality risk after adjustment for measured confounders. Further research is needed to evaluate the optimal glucose-lowering treatment for these high-risk patients.
(C) 2012 Springer. Part of Springer Science Business Media
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Author Keywords: | Coronary angiography; Coronary artery disease; Diabetes; Insulin; Mortality; Treatment.
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Language: | English.
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Document Type: | Article: PDF Only.
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ISSN: | 0012-186X
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NLM Journal Code: | e93, 0006777
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DOI Number: | https://dx.doi.org/10.1007/s0012...- ouverture dans une nouvelle fenêtre
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