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Peripheral neuropathy and the risk of cardiovascular events in type 2 diabetes mellitus.

Brownrigg, JR, de Lusignan, S, McGovern, A, Hughes, C, Thompson, MM, Ray, KK and Hinchliffe, RJ (2014) Peripheral neuropathy and the risk of cardiovascular events in type 2 diabetes mellitus. Heart, 100 (23). pp. 1837-1843.

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Abstract

AIMS: Identifying individuals with diabetes at high risk of cardiovascular disease (CVD) remains challenging. We aimed to establish whether peripheral neuropathy (PN) is associated with incident CVD events and to what extent information on PN may improve risk prediction among individuals with type 2 diabetes. METHODS: We obtained data for individuals with type 2 diabetes, and free of CVD, from a large primary care patient cohort. Incident CVD events were recorded during a 30-month follow-up period. Eligible individuals had complete ascertainment of cardiovascular risk factors and PN status at baseline. The association between PN and incident CVD events (non-fatal myocardial infarction, coronary revascularisation, congestive cardiac failure, transient ischaemic attack and stroke) was evaluated using Cox regression, adjusted for standard CVD risk factors. We assessed the predictive accuracy of models including conventional CVD risk factors with and without information on PN. RESULTS: Among 13 043 eligible individuals, we recorded 407 deaths from any cause and 399 non-fatal CVD events. After adjustment for age, sex, ethnicity, systolic blood pressure, cholesterol, body mass index, HbA1c, smoking status and use of statin or antihypertensive medication, PN was associated with incident CVD events (HR 1.33; 95% CI 1.02 to 1.75, p=0.04). The addition of information on PN to a model based on standard CVD risk factors resulted in modest improvements in discrimination for CVD risk prediction and reclassified 6.9% of individuals into different risk categories. CONCLUSIONS: PN is associated with increased risk for a first cardiovascular event among individuals with diabetes.

Item Type: Article
Subjects : Health Care Management
Divisions : Faculty of Arts and Social Sciences > Surrey Business School
Authors :
AuthorsEmailORCID
Brownrigg, JRUNSPECIFIEDUNSPECIFIED
de Lusignan, SUNSPECIFIEDUNSPECIFIED
McGovern, AUNSPECIFIEDUNSPECIFIED
Hughes, CUNSPECIFIEDUNSPECIFIED
Thompson, MMUNSPECIFIEDUNSPECIFIED
Ray, KKUNSPECIFIEDUNSPECIFIED
Hinchliffe, RJUNSPECIFIEDUNSPECIFIED
Date : December 2014
Identification Number : 10.1136/heartjnl-2014-305657
Copyright Disclaimer : Copyright 2015 BMJ Publishing Group
Uncontrolled Keywords : Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Diabetic Neuropathies, England, Female, Humans, Incidence, Kaplan-Meier Estimate, Male, Middle Aged, Peripheral Nervous System Diseases, Prognosis, Proportional Hazards Models, Risk Assessment, Risk Factors, Time Factors, Young Adult
Related URLs :
Additional Information : Full text not available from this repository.
Depositing User : Symplectic Elements
Date Deposited : 09 Jun 2016 09:28
Last Modified : 26 Jul 2016 10:09
URI: http://epubs.surrey.ac.uk/id/eprint/809868

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