Study Confirms Type 2 Diabetes Raises Heart Risks in Atherosclerosis - EMJ

Study Confirms Type 2 Diabetes Raises Heart Risks in Atherosclerosis

A NEW long-term study highlighted the significant role of type 2 diabetes (T2DM) in driving major adverse cardiovascular events (MACE) across different stages of atherosclerosis. The research, conducted by a team led by Arthur Mader and colleagues, analysed data from 1,238 patients over a median follow-up period of 7.1 years, covering over 9,500 patient-years. 

The study aimed to determine whether T2DM increases cardiovascular risks uniformly across various levels of atherosclerotic disease. Participants were divided into three groups based on their degree of atherosclerosis: those with no signs of disease, those with minor coronary atherosclerosis, and those with advanced symptomatic peripheral artery disease. 

The findings were striking: 51% of the total study population experienced MACE during the follow-up period, with a notably higher incidence in those with diabetes compared to non-diabetic individuals (p < 0.001). Additionally, the rate of MACE was strongly linked to the severity of atherosclerosis, occurring in 19.1% of patients with no atherosclerosis, 34.1% of those with minor atherosclerosis, and 58.1% of those with major atherosclerosis. 

In a multivariate analysis adjusting for traditional cardiovascular risk factors, T2DM remained an independent predictor of MACE (HR = 1.37, p = 0.034). Atherosclerosis itself also significantly predicted cardiovascular events (HR = 1.61, p < 0.001). However, the study found no significant interaction between diabetes and atherosclerosis severity, suggesting that the increased risk conferred by T2DM is consistent across all stages of arterial disease. 

The authors concluded that type 2 diabetes is a major independent driver of cardiovascular events, regardless of the extent of atherosclerotic disease. These findings reinforce the critical need for aggressive cardiovascular risk management in patients with diabetes, irrespective of their current stage of atherosclerosis. 

Aleksandra Zurowska, EMJ 

Reference 

Mader A et al. Contribution of type 2 diabetes to major adverse cardiovascular events (MACE) in a long-term observational study with different stages of atherosclerosis. Sci Rep. 2025;DOI: 10.1038/s41598-024-84985-x. 

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