Older adults with type 2 diabetes are at increased risk for death from cardiovascular complications, with the strongest associations found between survival and heart failure and vascular disease of the lower limbs, according to findings published in Diabetes Care.
of the department of diabetology-endocrinology at Villecresnes Medical Hospital in France, and colleagues evaluated data from the GERODIAB study on 987 adults (median age, 77 years) with type 2 diabetes (diabetes duration, 16 years) to assess CV complications during a 5-year follow-up and the associations with 5-year mortality.
Among the cohort, 21% died. CV complications were the most common reason for death (34.3%).
Compared with the time of inclusion, at 5 years, more participants had evidence of coronary heart disease (> 40% vs. 30%), heart failure (approximately 20% vs. 9%), vascular disease of the cerebral vessels (approximately 26% vs. 15%) and vascular disease of the lower limbs (approximately 35% vs. 25%).
Poor survival was strongly associated with heart failure (P < .0001) and vascular disease of the lower limbs (P = .0004). CHD (P = .0056) and vascular disease of the cerebral vessels (P = .026) were mildly associated with poor survival.
The strongest predictor of poor survival was heart failure in multivariate models (HR = 1.96; 95% CI, 1.45-2.64).
“All the cardiovascular complications under study were significantly associated with survival, but their associations did not show the same value; heart failure and vascular disease of the lower limbs were very strongly associated with death, whereas coronary heart disease and vascular disease of the cerebral vessels showed only mild associations. ... Obvious conclusions should however be considered with caution, because many treatments can be used to improve the progression of coronary heart disease and/or vascular disease, whereas heart failure is not so easy to improve or prevent,” the researchers wrote. – by Amber Cox
Disclosures: The study was funded by unrestricted grants from Merck Serono and Novo Nordisk. The authors report no relevant financial disclosures.