TYPE 2 DIABETES was associated with faster clinical progression of aortic stenosis in a nationwide Swedish study involving more than 47,000 patients.
Researchers linked nationwide Swedish healthcare registries to identify 16,116 individuals with both type 2 diabetes and incident aortic stenosis and compared them with 31,066 matched patients with aortic stenosis but without diabetes.
Clinical progression was defined as progression from aortic stenosis diagnosis to heart failure hospitalisation, aortic valve replacement, mortality, or a composite endpoint incorporating these outcomes.
The cohort had a mean age of 71 years, and patients with diabetes were younger, more likely to be male, and had a greater burden of comorbidities.
During follow up of up to 18 years, patients with type 2 diabetes experienced poorer outcomes across all measured endpoints than comparators without diabetes.
Overall, 63.9% of patients with diabetes reached the composite outcome compared with 58.5% of controls.
Heart failure hospitalisation rates were also higher, as were rates of transcatheter or surgical aortic valve replacement.
After adjustment for demographic factors, comorbidities, and medication use, type 2 diabetes remained independently associated with a greater likelihood of clinical deterioration.
Although unadjusted mortality was higher among patients with diabetes, this association disappeared after accounting for baseline characteristics and treatments. The adjusted risk of all-cause mortality was not significantly different between groups.
The researchers noted that diabetes may contribute to a less favourable clinical course after aortic stenosis diagnosis, even when mortality differences are not apparent.
They also acknowledged important limitations, including the absence of echocardiographic data on valve severity at diagnosis and valve morphology, which prevented assessment of whether patients with diabetes had more advanced disease at baseline.
The findings suggest that patients with both type 2 diabetes and aortic stenosis may require increased clinical awareness during follow-up.
According to the researchers, diabetes appeared to remain associated with a higher risk of heart failure hospitalisation, aortic valve replacement, and overall clinical progression despite extensive adjustment for comorbidities and medications.
Reference
Kontogeorgos S et al. Type 2 diabetes is associated with clinical progression of aortic stenosis: a nationwide retrospective study in Sweden. Sci Rep. 2026;DOI:10.1038/s41598-026-64970-2
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