Trends in cardiovascular admissions and procedures for people with and without diabetes in England, 1996-2005
Trends in cardiovascular admissions and procedures for people with and without diabetes in England, 1996-2005
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DOI：
10.1007/s00125-008-1170-1
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发表时间：
2009-01-01
期刊：
影响因子：
8.2
通讯作者：
Majeed, A.
中科院分区：
文献类型：
--
作者：
Bottle, A.;Millett, C.;Majeed, A.
目的/假设本研究的目的是比较10年来因心肌梗死、心绞痛、中风、经皮冠状动脉介入治疗（PCI）和冠状动脉旁路移植术（CABG）而入院的糖尿病和非糖尿病患者的趋势。结果总体而言，心绞痛入院人数略有下降，心肌梗死（MI）和中风入院人数变化不大。从1996/1997年到2005/2006年，MI、心绞痛和卒中中记录的糖尿病住院人数均有所上升; MI记录的2型糖尿病住院比例从7.2%上升至13.9%，心绞痛从6.7%上升至15.3%，卒中从6.2%上升至11.3%。在10年的时间里，在调整了年龄、性别和贫困因素后，接受冠状动脉旁路移植术的人数增加了约三倍;对于PCI，记录的糖尿病住院人数增加了15倍，相比之下，未记录的糖尿病入院人数增加了四倍。我们发现，因主要心血管事件和手术而入院的2型糖尿病患者数量显著增加，这对财政和公共卫生都有重要影响。需要在高危患者中更好地预防2型糖尿病，并在当前糖尿病患者中积极进行心血管危险因素管理。
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.