Type 2 diabetes patients with polyvascular disease at increased risk of MACE: EXSCEL trial

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-11-04T09:45:23+05:30 | Updated On 4 Nov 2021 11:20 AM IST

USA: The risk of MACE and mortality increases incrementally with each additional diseased arterial bed in patients with type 2 diabetes versus those without atherosclerotic vascular disease, show results from the Exenatide Study of Cardiovascular Event Lowering (EXSCEL) trial. The study was published in the journal Atherosclerosis on November 01, 2021.

Polyvascular disease is known to be an independent predictor of major adverse cardiovascular events (MACE) and all-cause mortality (ACM). The relationship between the number of diseased arterial beds and MACE, especially in type 2 diabetes (T2D) patients, is not known. Also, it is unknown of r heart failure (HF) status and hemoglobin A1c (HbA1c) levels influence outcomes in polyvascular disease.

Against the above background, Marc D. Samsky, Duke University School of Medicine, Durham, NC, USA, and colleagues' analysis from the EXSCEL trial was aimed to examine the risk associated with an increasing number of diseased arterial beds on MACE and ACM.

Cox models were used to test associations between the number of diseased arterial beds and MACE and ACM. The researchers also performed prespecified interaction testing between the number of diseased arterial beds with baseline HF, HbA1c (≤8% vs. >8%), and treatment assignment.

The study revealed the following findings:

14,751 participants were included; 26.5% were without atherosclerosis, 58.9% had 1-bed, 12.3% had 2-bed, and 2.3% had 3-bed disease
An increasing burden of atherosclerotic disease was associated with increasing risk of MACE (adjusted HR [aHR] 1.71; 2.61; 3.46 for 1, 2, and 3 beds, respectively) and ACM (1.94; 3.03; 3.66 for 1, 2, and 3 beds, respectively).
Prespecified interaction testing did not reveal any significant associations.

The researchers concluded, "In patients with T2D, compared to those without atherosclerotic vascular disease, risk of MACE and ACM increases incrementally with each additional diseased arterial bed."

Reference:

The study titled, "Polyvascular disease and increased risk of cardiovascular events in patients with type 2 diabetes: Insights from the EXSCEL trial," is published in the journal Atherosclerosis.

DOI: https://www.atherosclerosis-journal.com/article/S0021-9150(21)01409-X/fulltext

Atherosclerosis journaltype 2 diabetespolyvascular diseaseMACE

Source : Atherosclerosis journal

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751