Trends in incidence and case fatality of acute myocardial infarction, angina and coronary revascularisation in people with and without type 2 diabetes in Scotland between 2006 and 2015

Stephanie H. Read, Colin M. Fischbacher, Helen M. Colhoun, Danijela Gasevic, Joannes J. Kerssens, David A. McAllister, Naveed Sattar, Sarah H. Wild, on behalf of the Scottish Diabetes Research Network Epidemiology Group

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aims/hypothesis: The aim of the study was to examine trends in the incidence and case fatality of acute myocardial infarction (AMI) and in hospital admissions for angina and coronary revascularisation procedures in people with type 2 diabetes and in people without diabetes in Scotland between 2006 and 2015. Methods: In this retrospective cohort study, AMI, angina and revascularisation event data were obtained for adults from hospital admissions and death records linked to a population-based diabetes register. Incidence by diabetes status was estimated using negative binomial models with adjustment or stratification by age, sex, deprivation and calendar year. Logistic regression was used to estimate AMI case fatality by diabetes status. Results: There were 129,926 incident AMI events, 41,263 angina admissions and 69,875 coronary revascularisation procedures carried out during 34.9 million person-years of follow-up. The adjusted incidence of AMI, angina and revascularisation procedures declined by 2.0% (95% CI 1.73%, 2.26%), 9.62% (95% CI 9.22%, 10.01%) and 0.35% (95% CI −0.09%, 0.79%) per year, respectively. The rate of decline did not differ materially by diabetes status. RRs of AMI for type 2 diabetes were 1.86 (95% CI 1.74, 1.98) for men and 2.32 (95% CI 2.15, 2.51) for women. Of the 77,211 people admitted to hospital with a first AMI, 7842 (10.2%) died within 30 days of admission. Case fatality was higher in people with type 2 diabetes than in people without diabetes and declined in both groups by 7.93% (95% CI 7.03%, 8.82%) per year. Conclusions/interpretation: The incidence of AMI, angina, revascularisation and AMI case fatality has declined over time, but the increased risk associated with type 2 diabetes has remained approximately constant.

Original languageEnglish
Pages (from-to)418-425
Number of pages8
JournalDiabetologia
Volume62
Issue number3
DOIs
Publication statusPublished - 1 Mar 2019

Keywords

  • Angina
  • Coronary heart disease
  • Myocardial infarction
  • Revascularisation
  • Type 2 diabetes

Cite this

Read, S. H., Fischbacher, C. M., Colhoun, H. M., Gasevic, D., Kerssens, J. J., McAllister, D. A., ... on behalf of the Scottish Diabetes Research Network Epidemiology Group (2019). Trends in incidence and case fatality of acute myocardial infarction, angina and coronary revascularisation in people with and without type 2 diabetes in Scotland between 2006 and 2015. Diabetologia, 62(3), 418-425. https://doi.org/10.1007/s00125-018-4796-7
Read, Stephanie H. ; Fischbacher, Colin M. ; Colhoun, Helen M. ; Gasevic, Danijela ; Kerssens, Joannes J. ; McAllister, David A. ; Sattar, Naveed ; Wild, Sarah H. ; on behalf of the Scottish Diabetes Research Network Epidemiology Group. / Trends in incidence and case fatality of acute myocardial infarction, angina and coronary revascularisation in people with and without type 2 diabetes in Scotland between 2006 and 2015. In: Diabetologia. 2019 ; Vol. 62, No. 3. pp. 418-425.
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title = "Trends in incidence and case fatality of acute myocardial infarction, angina and coronary revascularisation in people with and without type 2 diabetes in Scotland between 2006 and 2015",
abstract = "Aims/hypothesis: The aim of the study was to examine trends in the incidence and case fatality of acute myocardial infarction (AMI) and in hospital admissions for angina and coronary revascularisation procedures in people with type 2 diabetes and in people without diabetes in Scotland between 2006 and 2015. Methods: In this retrospective cohort study, AMI, angina and revascularisation event data were obtained for adults from hospital admissions and death records linked to a population-based diabetes register. Incidence by diabetes status was estimated using negative binomial models with adjustment or stratification by age, sex, deprivation and calendar year. Logistic regression was used to estimate AMI case fatality by diabetes status. Results: There were 129,926 incident AMI events, 41,263 angina admissions and 69,875 coronary revascularisation procedures carried out during 34.9 million person-years of follow-up. The adjusted incidence of AMI, angina and revascularisation procedures declined by 2.0{\%} (95{\%} CI 1.73{\%}, 2.26{\%}), 9.62{\%} (95{\%} CI 9.22{\%}, 10.01{\%}) and 0.35{\%} (95{\%} CI −0.09{\%}, 0.79{\%}) per year, respectively. The rate of decline did not differ materially by diabetes status. RRs of AMI for type 2 diabetes were 1.86 (95{\%} CI 1.74, 1.98) for men and 2.32 (95{\%} CI 2.15, 2.51) for women. Of the 77,211 people admitted to hospital with a first AMI, 7842 (10.2{\%}) died within 30 days of admission. Case fatality was higher in people with type 2 diabetes than in people without diabetes and declined in both groups by 7.93{\%} (95{\%} CI 7.03{\%}, 8.82{\%}) per year. Conclusions/interpretation: The incidence of AMI, angina, revascularisation and AMI case fatality has declined over time, but the increased risk associated with type 2 diabetes has remained approximately constant.",
keywords = "Angina, Coronary heart disease, Myocardial infarction, Revascularisation, Type 2 diabetes",
author = "Read, {Stephanie H.} and Fischbacher, {Colin M.} and Colhoun, {Helen M.} and Danijela Gasevic and Kerssens, {Joannes J.} and McAllister, {David A.} and Naveed Sattar and Wild, {Sarah H.} and {on behalf of the Scottish Diabetes Research Network Epidemiology Group}",
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Read, SH, Fischbacher, CM, Colhoun, HM, Gasevic, D, Kerssens, JJ, McAllister, DA, Sattar, N, Wild, SH & on behalf of the Scottish Diabetes Research Network Epidemiology Group 2019, 'Trends in incidence and case fatality of acute myocardial infarction, angina and coronary revascularisation in people with and without type 2 diabetes in Scotland between 2006 and 2015' Diabetologia, vol. 62, no. 3, pp. 418-425. https://doi.org/10.1007/s00125-018-4796-7

Trends in incidence and case fatality of acute myocardial infarction, angina and coronary revascularisation in people with and without type 2 diabetes in Scotland between 2006 and 2015. / Read, Stephanie H.; Fischbacher, Colin M.; Colhoun, Helen M.; Gasevic, Danijela; Kerssens, Joannes J.; McAllister, David A.; Sattar, Naveed; Wild, Sarah H.; on behalf of the Scottish Diabetes Research Network Epidemiology Group.

In: Diabetologia, Vol. 62, No. 3, 01.03.2019, p. 418-425.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Trends in incidence and case fatality of acute myocardial infarction, angina and coronary revascularisation in people with and without type 2 diabetes in Scotland between 2006 and 2015

AU - Read, Stephanie H.

AU - Fischbacher, Colin M.

AU - Colhoun, Helen M.

AU - Gasevic, Danijela

AU - Kerssens, Joannes J.

AU - McAllister, David A.

AU - Sattar, Naveed

AU - Wild, Sarah H.

AU - on behalf of the Scottish Diabetes Research Network Epidemiology Group

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Y1 - 2019/3/1

N2 - Aims/hypothesis: The aim of the study was to examine trends in the incidence and case fatality of acute myocardial infarction (AMI) and in hospital admissions for angina and coronary revascularisation procedures in people with type 2 diabetes and in people without diabetes in Scotland between 2006 and 2015. Methods: In this retrospective cohort study, AMI, angina and revascularisation event data were obtained for adults from hospital admissions and death records linked to a population-based diabetes register. Incidence by diabetes status was estimated using negative binomial models with adjustment or stratification by age, sex, deprivation and calendar year. Logistic regression was used to estimate AMI case fatality by diabetes status. Results: There were 129,926 incident AMI events, 41,263 angina admissions and 69,875 coronary revascularisation procedures carried out during 34.9 million person-years of follow-up. The adjusted incidence of AMI, angina and revascularisation procedures declined by 2.0% (95% CI 1.73%, 2.26%), 9.62% (95% CI 9.22%, 10.01%) and 0.35% (95% CI −0.09%, 0.79%) per year, respectively. The rate of decline did not differ materially by diabetes status. RRs of AMI for type 2 diabetes were 1.86 (95% CI 1.74, 1.98) for men and 2.32 (95% CI 2.15, 2.51) for women. Of the 77,211 people admitted to hospital with a first AMI, 7842 (10.2%) died within 30 days of admission. Case fatality was higher in people with type 2 diabetes than in people without diabetes and declined in both groups by 7.93% (95% CI 7.03%, 8.82%) per year. Conclusions/interpretation: The incidence of AMI, angina, revascularisation and AMI case fatality has declined over time, but the increased risk associated with type 2 diabetes has remained approximately constant.

AB - Aims/hypothesis: The aim of the study was to examine trends in the incidence and case fatality of acute myocardial infarction (AMI) and in hospital admissions for angina and coronary revascularisation procedures in people with type 2 diabetes and in people without diabetes in Scotland between 2006 and 2015. Methods: In this retrospective cohort study, AMI, angina and revascularisation event data were obtained for adults from hospital admissions and death records linked to a population-based diabetes register. Incidence by diabetes status was estimated using negative binomial models with adjustment or stratification by age, sex, deprivation and calendar year. Logistic regression was used to estimate AMI case fatality by diabetes status. Results: There were 129,926 incident AMI events, 41,263 angina admissions and 69,875 coronary revascularisation procedures carried out during 34.9 million person-years of follow-up. The adjusted incidence of AMI, angina and revascularisation procedures declined by 2.0% (95% CI 1.73%, 2.26%), 9.62% (95% CI 9.22%, 10.01%) and 0.35% (95% CI −0.09%, 0.79%) per year, respectively. The rate of decline did not differ materially by diabetes status. RRs of AMI for type 2 diabetes were 1.86 (95% CI 1.74, 1.98) for men and 2.32 (95% CI 2.15, 2.51) for women. Of the 77,211 people admitted to hospital with a first AMI, 7842 (10.2%) died within 30 days of admission. Case fatality was higher in people with type 2 diabetes than in people without diabetes and declined in both groups by 7.93% (95% CI 7.03%, 8.82%) per year. Conclusions/interpretation: The incidence of AMI, angina, revascularisation and AMI case fatality has declined over time, but the increased risk associated with type 2 diabetes has remained approximately constant.

KW - Angina

KW - Coronary heart disease

KW - Myocardial infarction

KW - Revascularisation

KW - Type 2 diabetes

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U2 - 10.1007/s00125-018-4796-7

DO - 10.1007/s00125-018-4796-7

M3 - Article

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SP - 418

EP - 425

JO - Diabetologia

JF - Diabetologia

SN - 0012-186X

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