Improved trends in cardiovascular complications among subjects with type 2 diabetes in Korea: a nationwide study (2006-2013) - PubMed (original) (raw)

Chang Hee Jung et al. Cardiovasc Diabetol. 2017.

Abstract

Background: Representative data on the secular trends in cardiovascular disease (CVD) are limited in Asian populations with diabetes. We aimed to estimate the temporal trends in cardiovascular complications using Korean nationwide whole population-based claims data in subjects with and without diabetes.

Methods: Type 2 diabetes was defined as a current medication history of anti-diabetic drugs and the presence of International Classification of Diseases (ICD)-10 codes (E11-E14) as diagnosis. We compared the 8-year rates of six cardiovascular complications [i.e., ischemic heart disease, acute myocardial infarction (AMI), ischemic stroke, hemorrhagic stroke, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG)] in Korean adults aged 30 years and older using data from four consecutive nationwide databases (2006-2007, 2008-2009, 2010-2011, and 2012-2013) of Korean national health insurance service.

Results: A total of 1,645,348, 1,971,559, 2,291,247, and 2,562,612 subjects with type 2 diabetes were found in the year of 2006-2007, 2008-2009, 2010-2011, and 2012-2013, respectively. Age and gender standardized rates of the six predefined cardiovascular complications decreased in Korean adults with type 2 diabetes during the study period. The greatest relative reductions were observed for hospitalization due to AMI (-37.28%), followed by hospitalizations due to ischemic stroke (-36.98%). In the overall population without type 2 diabetes, the greatest relative reductions were observed for hospitalization for hemorrhagic stroke (-29.47%), followed by hospitalization due to ischemic stroke (-28.92%). Relative decreases in all six predefined cardiovascular complications were generally more profound in adults with diabetes than in those without diabetes, which led to significant decrease in the relative risks of all six cardiovascular complications in subjects with diabetes over the past 8 years. However, people with diabetes still had a two- to sixfold higher risk of hospitalization for major CVD events and interventions than people without diabetes.

Conclusions: Our findings suggest a significant reduction in the rate of people affected by CVD within the diabetic population. However, as the number of people with diabetes rises, the absolute burden of CVD will still be high in Korea.

Keywords: Cardiovascular disease; Complications; National; Trend; Type 2 diabetes.

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Figures

Fig. 1

Fig. 1

Age and gender standardized events (per 10,000 adults) of six cardiovascular complications in populations a with diabetes, and b without diabetes

Fig. 2

Fig. 2

Relative risks of six cardiovascular complications in subjects with diabetes compared with subjects without diabetes. a Ischemic heart disease, b acute myocardial infarction (AMI), c ischemic stroke, d hemorrhagic stroke, e percutaneous coronary intervention (PCI), and f coronary artery bypass and graft (CABG)

Fig. 3

Fig. 3

Age and gender standardized prevalence of hypertension and dyslipidemia in populations a with diabetes, and b without diabetes

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