Diabetes, Heart, and Cardiovascular Diseases News Chronicle.      Article 306

Common Causes Of Death In The Patients Suffering From Both Type 2 Diabetes And Atherosclerotic Cardiovascular Diseases (ASCVD)

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An earlier study shows that the heart attack (acute myocardial infarction is the medical name. MI) is causing the maximum number of deaths and type 2 diabetes (T2D) may be linked with other causes of death such as cancer, heart failure, sudden death and noncardiovascular deaths.

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A cut in the cardiovascular death (mortality) by preventing a heart failure and lower blood sugar (glucose) levels.

A three-year, double-blind and Placebo-controlled study called TECOS (Trial Evaluating Cardiovascular Outcomes with Sitagliptin) has studied the causes, risk factors and prevention of mortality (death) in patients suffering from both atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes.

Researchers have evaluated the effects of Sitagliptin (DPP-4 Inhibitor) drug along with their current drug therapy on patients suffering from both atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes. The total number of the participants in the study are 14,735, aged more than 50 years. All of them are diagnosed with both type 2 diabetes and atherosclerotic cardiovascular diseases (ASCVD). They are selected randomly into the study groups of either Placebo or Sitagliptin. Researchers used the Cox proportional hazard model to determine the risk factor associated with the cause of death.

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During a three-year follow-up study, the researchers have observed the following deaths due to various causes.

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Cause of death Number of deaths (%)
Cardiovascular diseases 530 (49%)
noncardiovascular diseases 338 (31%)
Unknown reasons 216 (20%)
Total deaths 1084

The malignancy was seen in 46 percent of deaths (145) in the deaths due to a non-cardiovascular disease.

The following table shows the causes and number of deaths due to cardiovascular diseases.

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Cause of death Number of deaths (%)
Sudden death 145 (27%)
Myocardial infarction (MI) or stroke 113 (21%)
Heart failure 63 (12%)

The study shows a decrease in cardiovascular death (mortality) such as sudden death, stroke and heart failure in the patients without a heart failure history. Cardiovascular mortality can be lowered with measures such as the prevention of heart failure, lowering blood sugar (glucose) levels (HbA1c) and eGFR preservation.

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The study also found a lower risk of all-cause mortality in women with a high estimated glomerular filtration (eGFR) and having a history of percutaneous coronary intervention (coronary angioplasty. PCI).

The study found a higher risk of all-cause mortality with an increase in age, with an increase in blood sugar (glucose) levels (HbA1c) and with a history of heart attack (myocardial infarction. MI).

This study shows the "Sudden Death" is the most frequent cause of death in the deaths related to cardiovascular diseases in patients of both type 2 diabetes and atherosclerotic cardiovascular diseases (ASCVD). But the reasons for the "Sudden Death" are not known. Researchers say that further investigation is required to uncover the mechanism.

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Limitations of this study are:

  • The causes of death in about 20 percent of participants are not known.
  • Nonavailability of ejection fraction data.
  • The TECOS study may not reflect the atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes in the general population.

The corresponding author of the study was Abhinav Sharma, MD, Cardiologist, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, the United States. The study was published October 6, 2017, in the Diabetes Care. Title of the article was "Causes of Death in a Contemporary Cohort of Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease: Insights From the TECOS Trial."
DOI: doi.org/10.2337/dc17-1091

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Published on February 15, 2018


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