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Erschienen in: Diabetologia 1/2009

01.01.2009 | Article

Trends in cardiovascular admissions and procedures for people with and without diabetes in England, 1996–2005

verfasst von: A. Bottle, C. Millett, K. Khunti, A. Majeed

Erschienen in: Diabetologia | Ausgabe 1/2009

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Abstract

Aims/hypothesis

The aim of this study was to compare 10-year trends in admissions, with and without diabetes recorded, for myocardial infarction, angina, stroke, percutaneous coronary interventions (PCI) and coronary artery bypass graft (CABG).

Methods

We used national hospital-activity data in England collected between 1996 and 2005 and compared trends in admissions, after adjusting for age, sex and area-level deprivation.

Results

Overall, there was a modest fall in the number of admissions for angina and little change in the numbers of admissions for myocardial infarction (MI) and stroke. From 1996/1997 to 2005/2006, the numbers of admissions with diabetes recorded rose for each of MI, angina and stroke; the proportion of admissions with type 2 diabetes recorded rose from 7.2% to 13.9% for MI, from 6.7% to 15.3% for angina and from 6.2% to 11.3% for stroke. Over the 10-year period, after adjusting for age, sex and deprivation, the number of admissions for CABG rose about threefold; for PCI, the number of admissions with diabetes recorded rose 15-fold, compared with a fourfold increase in the number of admissions with diabetes not recorded.

Conclusions/interpretation

We found significant increases in the numbers of admissions with type 2 diabetes recorded for major cardiovascular events and procedures, which has important financial and public-health implications. Better prevention of type 2 diabetes in at-risk patients and aggressive cardiovascular risk-factor management in current patients with diabetes is needed.
Literatur
1.
Zurück zum Zitat Lipscombe LL, Hux JE (2007) Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada 1995–2005: a population-based study. Lancet 369:750–756PubMedCrossRef Lipscombe LL, Hux JE (2007) Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada 1995–2005: a population-based study. Lancet 369:750–756PubMedCrossRef
2.
Zurück zum Zitat Kannel WB, McGee DL (1979) Diabetes and cardiovascular disease. The Framingham study. JAMA 241:2035–2038PubMedCrossRef Kannel WB, McGee DL (1979) Diabetes and cardiovascular disease. The Framingham study. JAMA 241:2035–2038PubMedCrossRef
3.
Zurück zum Zitat Caro JJ, Ward AJ, O’Brien JA (2002) Lifetime costs of complications resulting from type 2 diabetes in the U.S. Diabetes Care 25:476–481PubMedCrossRef Caro JJ, Ward AJ, O’Brien JA (2002) Lifetime costs of complications resulting from type 2 diabetes in the U.S. Diabetes Care 25:476–481PubMedCrossRef
4.
Zurück zum Zitat Gillum RF (1994) Trends in acute myocardial infarction and coronary heart disease death in the United States. J Am Coll Cardiol 23:1273–1277PubMedCrossRef Gillum RF (1994) Trends in acute myocardial infarction and coronary heart disease death in the United States. J Am Coll Cardiol 23:1273–1277PubMedCrossRef
5.
Zurück zum Zitat Gregg EW, Gu Q, Cheng YJ, Narayan KM, Cowie CC (2007) Mortality trends in men and women with diabetes, 1971 to 2000. Ann Intern Med 147:149–155PubMed Gregg EW, Gu Q, Cheng YJ, Narayan KM, Cowie CC (2007) Mortality trends in men and women with diabetes, 1971 to 2000. Ann Intern Med 147:149–155PubMed
6.
Zurück zum Zitat Imperatore G, Cadwell BL, Geiss L et al (2004) Thirty-year trends in cardiovascular risk factor levels among US adults with diabetes: National Health and Nutrition Examination Surveys, 1971–2000. Am J Epidemiol 160:531–539PubMedCrossRef Imperatore G, Cadwell BL, Geiss L et al (2004) Thirty-year trends in cardiovascular risk factor levels among US adults with diabetes: National Health and Nutrition Examination Surveys, 1971–2000. Am J Epidemiol 160:531–539PubMedCrossRef
7.
Zurück zum Zitat Saaddine JB, Cadwell B, Gregg EW et al (2006) Improvements in diabetes processes of care and intermediate outcomes: United States, 1988–2002. Ann Intern Med 144:465–474PubMed Saaddine JB, Cadwell B, Gregg EW et al (2006) Improvements in diabetes processes of care and intermediate outcomes: United States, 1988–2002. Ann Intern Med 144:465–474PubMed
8.
Zurück zum Zitat Fox CS, Coady S, Sorlie PD et al (2004) Trends in cardiovascular complications of diabetes. JAMA 292:2495–2499PubMedCrossRef Fox CS, Coady S, Sorlie PD et al (2004) Trends in cardiovascular complications of diabetes. JAMA 292:2495–2499PubMedCrossRef
9.
Zurück zum Zitat Gu K, Cowie CC, Harris MI (1999) Diabetes and decline in heart disease mortality in US adults. JAMA 281:1291–1297PubMedCrossRef Gu K, Cowie CC, Harris MI (1999) Diabetes and decline in heart disease mortality in US adults. JAMA 281:1291–1297PubMedCrossRef
10.
Zurück zum Zitat Booth GL, Kapral MK, Fung K, Tu JV (2006) Recent trends in cardiovascular complications among men and women with and without diabetes. Diabetes Care 29:32–37PubMedCrossRef Booth GL, Kapral MK, Fung K, Tu JV (2006) Recent trends in cardiovascular complications among men and women with and without diabetes. Diabetes Care 29:32–37PubMedCrossRef
11.
Zurück zum Zitat Alexander S, Peto P, Scarborough P et al (2006). Coronary Heart Disease Statistics Fact Sheet 2006. Available from http://www.heartstats.org/, accessed 24 September 2008. London, British Heart Foundation Alexander S, Peto P, Scarborough P et al (2006). Coronary Heart Disease Statistics Fact Sheet 2006. Available from http://​www.​heartstats.​org/​, accessed 24 September 2008. London, British Heart Foundation
12.
Zurück zum Zitat Sytkowski PA, Kannel WB, D’Agostino RB (1990) Changes in risk factors and the decline in mortality from cardiovascular disease. The Framingham Heart Study. N Engl J Med 322:1635–1641PubMed Sytkowski PA, Kannel WB, D’Agostino RB (1990) Changes in risk factors and the decline in mortality from cardiovascular disease. The Framingham Heart Study. N Engl J Med 322:1635–1641PubMed
13.
Zurück zum Zitat Unal B, Critchley JA, Capewell S (2004) Explaining the decline in coronary heart disease mortality in England and Wales between 1981 and 2000. Circulation 109:1101–1107PubMedCrossRef Unal B, Critchley JA, Capewell S (2004) Explaining the decline in coronary heart disease mortality in England and Wales between 1981 and 2000. Circulation 109:1101–1107PubMedCrossRef
14.
Zurück zum Zitat Carstairs V, Morris G (1991) Deprivation and health in Scotland. Aberdeen University Press, Aberdeen Carstairs V, Morris G (1991) Deprivation and health in Scotland. Aberdeen University Press, Aberdeen
15.
Zurück zum Zitat Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Diagnosis and classification of diabetes mellitus: provisional report of a WHO consultation. Diabet Med 15:539–553PubMedCrossRef Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Diagnosis and classification of diabetes mellitus: provisional report of a WHO consultation. Diabet Med 15:539–553PubMedCrossRef
16.
Zurück zum Zitat Natali A, Vichi S, Landi P, Severi S, L’Abbate A, Ferrannini E (2000) Coronary atherosclerosis in type II diabetes: angiographic findings and clinical outcome. Diabetologia 43:632–641PubMedCrossRef Natali A, Vichi S, Landi P, Severi S, L’Abbate A, Ferrannini E (2000) Coronary atherosclerosis in type II diabetes: angiographic findings and clinical outcome. Diabetologia 43:632–641PubMedCrossRef
17.
Zurück zum Zitat Waller BF, Palumbo PJ, Lie JT, Roberts WC (1980) Status of the coronary arteries at necropsy in diabetes mellitus with onset after age 30 years. Analysis of 229 diabetic patients with and without clinical evidence of coronary heart disease and comparison to 183 control subjects. Am J Med 69:498–506PubMedCrossRef Waller BF, Palumbo PJ, Lie JT, Roberts WC (1980) Status of the coronary arteries at necropsy in diabetes mellitus with onset after age 30 years. Analysis of 229 diabetic patients with and without clinical evidence of coronary heart disease and comparison to 183 control subjects. Am J Med 69:498–506PubMedCrossRef
18.
Zurück zum Zitat Khunti K, Gadsby R, Millett C, Majeed A, Davies MJ (2007) Quality of diabetes care in the UK: comparison of published quality of care reports with results of the Quality and Outcomes Framework for Diabetes. Diabet Med 24:1436–1441PubMedCrossRef Khunti K, Gadsby R, Millett C, Majeed A, Davies MJ (2007) Quality of diabetes care in the UK: comparison of published quality of care reports with results of the Quality and Outcomes Framework for Diabetes. Diabet Med 24:1436–1441PubMedCrossRef
19.
Zurück zum Zitat Persell SD, Baker DW (2004) Aspirin use among adults with diabetes: recent trends and emerging sex disparities. Arch Intern Med 164:2492–2499PubMedCrossRef Persell SD, Baker DW (2004) Aspirin use among adults with diabetes: recent trends and emerging sex disparities. Arch Intern Med 164:2492–2499PubMedCrossRef
20.
21.
Zurück zum Zitat Leslie PJ, Patrick AW, Hepburn DA, Scougal IJ, Frier BM (1992) Hospital inpatient statistics underestimate the morbidity associated with diabetes mellitus. Diabet Med 9:379–385PubMedCrossRef Leslie PJ, Patrick AW, Hepburn DA, Scougal IJ, Frier BM (1992) Hospital inpatient statistics underestimate the morbidity associated with diabetes mellitus. Diabet Med 9:379–385PubMedCrossRef
22.
Zurück zum Zitat Campbell SE, Campbell MK, Grimshaw JM, Walker AE (2001) A systematic review of discharge coding accuracy. J Public Health Med 23:205–211PubMedCrossRef Campbell SE, Campbell MK, Grimshaw JM, Walker AE (2001) A systematic review of discharge coding accuracy. J Public Health Med 23:205–211PubMedCrossRef
23.
Zurück zum Zitat Dixon J, Sanderson C, Elliott P, Walls P, Jones J, Petticrew M (1998) Assessment of the reproducibility of clinical coding in routinely collected hospital activity data: a study of two hospitals. J Pub Health Med 20:63–69 Dixon J, Sanderson C, Elliott P, Walls P, Jones J, Petticrew M (1998) Assessment of the reproducibility of clinical coding in routinely collected hospital activity data: a study of two hospitals. J Pub Health Med 20:63–69
Metadaten
Titel
Trends in cardiovascular admissions and procedures for people with and without diabetes in England, 1996–2005
verfasst von
A. Bottle
C. Millett
K. Khunti
A. Majeed
Publikationsdatum
01.01.2009
Verlag
Springer-Verlag
Erschienen in
Diabetologia / Ausgabe 1/2009
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-008-1170-1

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