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Life expectancy following a cardiovascular event in individuals with and without type 2 diabetes: A UK multi-ethnic population-based observational study

Life expectancy following a cardiovascular event in individuals with and without type 2 diabetes: A UK multi-ethnic population-based observational study
Life expectancy following a cardiovascular event in individuals with and without type 2 diabetes: A UK multi-ethnic population-based observational study
Background and Aims We aimed to evaluate the life expectancy following the first cardiovascular disease (CVD) event by type 2 diabetes (T2D) status and ethnicity. Methods and Results We used the Clinical Practice Research Datalink database in England (UK), linked to the Hospital Episode Statistics information, to identify individuals with and without T2D who survived a first CVD event between 1st Jan 2007 and 31st Dec 2017; subsequent death events were extracted from the Office for National Statistics database. Ethnicity was categorised as White, South Asian (SA), Black, or other. Flexible parametric survival models were used to estimate survival and predict life expectancy. 59,939 individuals with first CVD event were included: 7,596 (12.7%) with T2D (60.9% men; mean age at event: 69.7 years [63.2 years in SA, 65.9 in Black, 70.2 in White]) and 52,343 without T2D (56.7% men; 65.9 years [54.7 in Black, 58.2 in SA, 66.3 in White]). Accounting for potential confounders (sex, deprivation, lipid-lowering medication, current smoking, and pre-existing hypertension), comparing individuals with vs without T2D the mortality rate was 53% higher in White (hazard ratio [HR]: 1.53 [95% CI: 1.44, 1.62]), corresponding to a potential loss of 3.87 (3.30, 4.44) life years at the age of 50 years in individuals with T2D. No evidence of a difference in life expectancy was observed in individuals of SA (HR: 0.82 [0.52, 1.29]; -1.36 [-4.58, 1.86] life years), Black (HR: 1.26 [0.59, 2.70]; 1.21 [-2.99, 5.41] life years); and other (HR: 1.64 [0.80, 3.39]; 3.89 [-2.28, 9.99] life years) ethnic group. Conclusion Following a CVD event, T2D is associated with a different prognosis and life years lost among ethnic groups.
cardiovascular disease, diabetes, life expectancy, prognosis, years of life lost, Life expectancy, Prognosis, Cardiovascular disease, Diabetes, Years of life lost
0939-4753
1358-1366
Chudasama, Yogini V.
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Khunti, Kamlesh
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Coles, Briana
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Gillies, Clare L.
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Islam, Nazrul
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Rowlands, Alex V.
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Seidu, Samuel
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Razieh, Cameron
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Davies, Melanie J.
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Samani, Nilesh J.
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Yates, Thomas
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Zaccardi, Francesco
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Chudasama, Yogini V.
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Khunti, Kamlesh
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Coles, Briana
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Gillies, Clare L.
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Islam, Nazrul
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Rowlands, Alex V.
881cca19-ef16-40b6-880e-4de367a2ade8
Seidu, Samuel
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Razieh, Cameron
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Davies, Melanie J.
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Samani, Nilesh J.
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Yates, Thomas
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Zaccardi, Francesco
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Chudasama, Yogini V., Khunti, Kamlesh, Coles, Briana, Gillies, Clare L., Islam, Nazrul, Rowlands, Alex V., Seidu, Samuel, Razieh, Cameron, Davies, Melanie J., Samani, Nilesh J., Yates, Thomas and Zaccardi, Francesco (2023) Life expectancy following a cardiovascular event in individuals with and without type 2 diabetes: A UK multi-ethnic population-based observational study. Nutrition, Metabolism and Cardiovascular Diseases, 33 (7), 1358-1366. (doi:10.1016/j.numecd.2023.04.003).

Record type: Article

Abstract

Background and Aims We aimed to evaluate the life expectancy following the first cardiovascular disease (CVD) event by type 2 diabetes (T2D) status and ethnicity. Methods and Results We used the Clinical Practice Research Datalink database in England (UK), linked to the Hospital Episode Statistics information, to identify individuals with and without T2D who survived a first CVD event between 1st Jan 2007 and 31st Dec 2017; subsequent death events were extracted from the Office for National Statistics database. Ethnicity was categorised as White, South Asian (SA), Black, or other. Flexible parametric survival models were used to estimate survival and predict life expectancy. 59,939 individuals with first CVD event were included: 7,596 (12.7%) with T2D (60.9% men; mean age at event: 69.7 years [63.2 years in SA, 65.9 in Black, 70.2 in White]) and 52,343 without T2D (56.7% men; 65.9 years [54.7 in Black, 58.2 in SA, 66.3 in White]). Accounting for potential confounders (sex, deprivation, lipid-lowering medication, current smoking, and pre-existing hypertension), comparing individuals with vs without T2D the mortality rate was 53% higher in White (hazard ratio [HR]: 1.53 [95% CI: 1.44, 1.62]), corresponding to a potential loss of 3.87 (3.30, 4.44) life years at the age of 50 years in individuals with T2D. No evidence of a difference in life expectancy was observed in individuals of SA (HR: 0.82 [0.52, 1.29]; -1.36 [-4.58, 1.86] life years), Black (HR: 1.26 [0.59, 2.70]; 1.21 [-2.99, 5.41] life years); and other (HR: 1.64 [0.80, 3.39]; 3.89 [-2.28, 9.99] life years) ethnic group. Conclusion Following a CVD event, T2D is associated with a different prognosis and life years lost among ethnic groups.

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Accepted/In Press date: 5 April 2023
e-pub ahead of print date: 11 April 2023
Published date: July 2023
Additional Information: Funding Information: This study is based on data from the CPRD-GOLD database obtained under licence from the UK Medicines and Healthcare products Regulatory Agency. However, the interpretation and conclusions contained in this article are those of the authors alone. The authors gratefully acknowledge Leicester Real-World Evidence Unit (LRWE) for facilitating the download of CPRD data. LRWE is funded by the University of Leicester, NIHR Applied Research Collaboration East Midlands (ARC) and Leicester Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Funding Information: This study is based on data from the CPRD-GOLD database obtained under licence from the UK Medicines and Healthcare products Regulatory Agency. However, the interpretation and conclusions contained in this article are those of the authors alone. The authors gratefully acknowledge Leicester Real-World Evidence Unit (LRWE) for facilitating the download of CPRD data. LRWE is funded by the University of Leicester, NIHR Applied Research Collaboration East Midlands (ARC) and Leicester Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2023 The Authors
Keywords: cardiovascular disease, diabetes, life expectancy, prognosis, years of life lost, Life expectancy, Prognosis, Cardiovascular disease, Diabetes, Years of life lost

Identifiers

Local EPrints ID: 476731
URI: http://eprints.soton.ac.uk/id/eprint/476731
ISSN: 0939-4753
PURE UUID: c4018d7a-510a-4a97-a99e-0b7b2d746470
ORCID for Nazrul Islam: ORCID iD orcid.org/0000-0003-3982-4325

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Date deposited: 12 May 2023 16:54
Last modified: 17 Mar 2024 04:15

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Contributors

Author: Yogini V. Chudasama
Author: Kamlesh Khunti
Author: Briana Coles
Author: Clare L. Gillies
Author: Nazrul Islam ORCID iD
Author: Alex V. Rowlands
Author: Samuel Seidu
Author: Cameron Razieh
Author: Melanie J. Davies
Author: Nilesh J. Samani
Author: Thomas Yates
Author: Francesco Zaccardi

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