Author + information
- Paul Muntner,
- Rikki Tanner,
- Huifeng Yun,
- April Carson,
- Stephen Glasser,
- George Howard,
- Evan Thacker,
- Michael Farkouh,
- Robert Rosenson,
- Todd Brown,
- Monika Safford and
- Emily Levitan
Substantial efforts have been made over the past two decades to reduce the incidence of coronary heart disease (CHD) among people with diabetes. Few data are available on secular trends in CHD incidence and mortality among people with diabetes over this time period.
We compared CHD incidence, mortality and case-fatality among adults 45 to 64 years of age with diabetes (fasting glucose ≥ 126 mg/dL or medication use) in 1987-1993 and 2003-2009 using data from the Atherosclerosis Risk in Communities Study (ARIC) and the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, respectively. All CHD events and deaths were adjudicated.
In ARIC (1987-1993) and REGARDS (2003-2009), the mean (SD) age of participants with diabetes was 55.7 (5.7) and 58.1 (4.5), 54.8% and 55.8% were women, and 43.9% and 61.7% were black. The age, race, sex-adjusted CHD incidence declined from 14.4 (95% CI: 12.3 – 16.9) to 8.1 (95%: 6.6 – 9.9) per 1,000 person-years between 1987-1993 and 2003-2009 (p<0.001). A decline was also observed for age, race, sex-adjusted adjusted CHD mortality (Figure, p<0.001). Among people hospitalized for CHD, the 28- and 365-day case-fatality rate did not decline over this time period (each p>0.40).
Between 1987-1993 and 2003-2009, CHD incidence and mortality declined among middle-aged adults with diabetes but no change in case-fatality occurred. Efforts are needed to reduce case-fatality among people with diabetes following hospitalization for CHD.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Disparities and Cardiovascular Epidemiology
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1244-104
- 2013 American College of Cardiology Foundation