Diabetic medicine : a journal of the British Diabetic Association · 2026
Incidence and associates of aortic valve replacement in people with or without type 2 diabetes: The Fremantle diabetes study phase II.
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Davis Timothy M E, Davis Wendy A
Аннотация
AIMS: To utilise Fremantle Diabetes Study Phase II (FDS2) data to examine the association between Type 2 diabetes and incident aortic valve replacement (AVR) and to investigate potential risk factors in Type 2 diabetes.
METHODS: We followed 1430 FDS2 participants (mean age 66 years, 53% males) and 5720 age-, sex-, and postcode-matched people without diabetes from entry (2008-2011) to end-2021 for AVR ascertained from validated linked databases. Incidence rate ratios (IRRs) were calculated. Cox proportional hazards and competing risk models generated cause-specific (cs) and subdistribution (sd) hazard ratios (HRs) for incident AVR.
RESULTS: At baseline, 11 participants with Type 2 diabetes (0.8%) and 37 without diabetes (0.6%) had undergone AVR (p = 0.589). There were 24 (1.7%) and 40 (0.7%) first incident AVR hospitalisations, respectively, in the two groups during 73,498 person-years of follow-up (IRR 2.40 [95% confidence interval (CI) 1.38, 4.08], p = 0.0007). In pooled analyses, Type 2 diabetes had similar csHR (2.38 [1.43, 3.96]) and sdHR (2.34 [1.41, 3.88]), with increasing age and male sex as other statistically significant covariates. In Type 2 diabetes, incident AVR was bivariably associated with baseline blood glucose-lowering treatment intensity (p = 0.003) and with distal symmetrical polyneuropathy (DSPN) after age and sex adjustment (p = 0.025).
CONCLUSIONS: Type 2 diabetes more than doubles the risk of AVR after adjusting for the competing risk of death. People with Type 2 diabetes going on to require AVR were more intensively managed and were more likely to have DSPN at baseline.
METHODS: We followed 1430 FDS2 participants (mean age 66 years, 53% males) and 5720 age-, sex-, and postcode-matched people without diabetes from entry (2008-2011) to end-2021 for AVR ascertained from validated linked databases. Incidence rate ratios (IRRs) were calculated. Cox proportional hazards and competing risk models generated cause-specific (cs) and subdistribution (sd) hazard ratios (HRs) for incident AVR.
RESULTS: At baseline, 11 participants with Type 2 diabetes (0.8%) and 37 without diabetes (0.6%) had undergone AVR (p = 0.589). There were 24 (1.7%) and 40 (0.7%) first incident AVR hospitalisations, respectively, in the two groups during 73,498 person-years of follow-up (IRR 2.40 [95% confidence interval (CI) 1.38, 4.08], p = 0.0007). In pooled analyses, Type 2 diabetes had similar csHR (2.38 [1.43, 3.96]) and sdHR (2.34 [1.41, 3.88]), with increasing age and male sex as other statistically significant covariates. In Type 2 diabetes, incident AVR was bivariably associated with baseline blood glucose-lowering treatment intensity (p = 0.003) and with distal symmetrical polyneuropathy (DSPN) after age and sex adjustment (p = 0.025).
CONCLUSIONS: Type 2 diabetes more than doubles the risk of AVR after adjusting for the competing risk of death. People with Type 2 diabetes going on to require AVR were more intensively managed and were more likely to have DSPN at baseline.