AustralieFrV1, Main, Curation, bibRecord, 001905

Presentations of major peripheral arterial disease and risk of major outcomes in patients with type 2 diabetes: results from the ADVANCE-ON study

Identifieur interne : 001905 ( Main/Curation ); précédent : 001904; suivant : 001906

Presentations of major peripheral arterial disease and risk of major outcomes in patients with type 2 diabetes: results from the ADVANCE-ON study

Auteurs : Kamel Mohammedi [Australie] ; Mark Woodward [Australie, Royaume-Uni, États-Unis] ; Yoichiro Hirakawa [Australie] ; Sophia Zoungas [Australie] ; Stephen Colagiuri [Australie] ; Pavel Hamet [Canada] ; Stephen Harrap ; Neil Poulter [Royaume-Uni] ; David R. Matthews [Royaume-Uni] ; Michel Marre [France] ; John Chalmers [Australie]

Source :

Cardiovascular Diabetology [ 1475-2840 ] ; 2016.

RBID : PMC:5010714

Descripteurs français

English descriptors

KwdEn :
- Aged, Amputation, Angioplasty, Diabetes Mellitus, Type 2 (complications), Diabetes Mellitus, Type 2 (diagnosis), Diabetes Mellitus, Type 2 (drug therapy), Diabetes Mellitus, Type 2 (mortality), Diabetic Angiopathies (diagnosis), Diabetic Angiopathies (etiology), Diabetic Angiopathies (mortality), Diabetic Angiopathies (therapy), Diabetic Retinopathy (etiology), Female, Humans, Hypoglycemic Agents (therapeutic use), Leg Ulcer (etiology), Limb Salvage, Lower Extremity (blood supply), Male, Middle Aged, Peripheral Arterial Disease (diagnosis), Peripheral Arterial Disease (etiology), Peripheral Arterial Disease (mortality), Peripheral Arterial Disease (therapy), Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Vascular Surgical Procedures.
MESH :
- chemical , therapeutic use : Hypoglycemic Agents.
- blood supply : Lower Extremity.
- complications : Diabetes Mellitus, Type 2.
- diagnosis : Diabetes Mellitus, Type 2, Diabetic Angiopathies, Peripheral Arterial Disease.
- drug therapy : Diabetes Mellitus, Type 2.
- etiology : Diabetic Angiopathies, Diabetic Retinopathy, Leg Ulcer, Peripheral Arterial Disease.
- mortality : Diabetes Mellitus, Type 2, Diabetic Angiopathies, Peripheral Arterial Disease.
- therapy : Diabetic Angiopathies, Peripheral Arterial Disease.
- Aged, Amputation, Angioplasty, Female, Humans, Limb Salvage, Male, Middle Aged, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Vascular Surgical Procedures.

Abstract

Background

Peripheral arterial disease (PAD) is known to be associated with high cardiovascular risk, but the individual impact of PAD presentations on risk of macrovascular and microvascular events has not been reliably compared in patients with type 2 diabetes. We aimed to evaluate the impact of major PAD, and its different presentations, on the 10-year risk of death, major macrovascular events, and major clinical microvascular events in these patients.

Methods

Participants in the action in diabetes and vascular disease: PreterAx and DiamicroN modified-release controlled evaluation (ADVANCE) trial and the ADVANCE-ON post-trial study were followed for a median of 5.0 (in-trial), 5.4 (post-trial), and 9.9 (overall) years. Major PAD at baseline was subdivided into lower-extremity chronic ulceration or amputation secondary to vascular disease and history of peripheral revascularization by angioplasty or surgery.

Results

Among 11,140 participants, 516 (4.6 %) had major PAD at baseline: 300 (2.7 %) had lower-extremity ulceration or amputation alone, 190 (1.7 %) had peripheral revascularization alone, and 26 (0.2 %) had both presentations. All-cause mortality, major macrovascular events, and major clinical microvascular events occurred in 2265 (20.3 %), 2166 (19.4 %), and 807 (7.2 %) participants, respectively. Compared to those without PAD, patients with major PAD had increased rates of all-cause mortality (HR 1.35, 95 % CI 1.15–1.60, p = 0.0004), and major macrovascular events (1.47 [1.23–1.75], p < 0.0001), after multiple adjustments for region of origin, cardiovascular risk factors and treatments, peripheral neuropathy markers, and randomized treatments. We have also observed a trend toward an association of baseline PAD with risk of major clinical microvascular events [1.31 (0.96–1.78), p = 0.09]. These associations were comparable for patients with a lower-extremity ulceration or amputation and for those with a history of peripheral revascularization. Furthermore, the risk of retinal photocoagulation or blindness, but not renal events, increased in patients with lower-extremity ulceration or amputation [1.53 (1.01–2.30), p = 0.04].

Conclusions

Lower-extremity ulceration or amputation, and peripheral revascularization both increased the risks of death and cardiovascular events, but only lower-extremity ulceration or amputation increased the risk of severe retinopathy in patients with type 2 diabetes. Screening for major PAD and its management remain crucial for cardiovascular prevention in patients with type 2 diabetes (ClinicalTrials.gov number, NCT00949286).

Electronic supplementary material

The online version of this article (doi:10.1186/s12933-016-0446-x) contains supplementary material, which is available to authorized users.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010714

DOI: 10.1186/s12933-016-0446-x
PubMed: 27590190
PubMed Central: 5010714

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Sophia Zoungas

<affiliation><nlm:aff id="Aff4">Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC Australia</nlm:aff>
<wicri:noCountry code="subfield">VIC Australia</wicri:noCountry>
</affiliation>

Stephen Harrap

<affiliation><nlm:aff id="Aff7">The University of Melbourne and Royal Melbourne Hospital, Melbourne, VIC Australia</nlm:aff>
<wicri:noCountry code="subfield">VIC Australia</wicri:noCountry>
</affiliation>

Le document en format XML

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<affiliation wicri:level="3"><nlm:aff id="Aff12">Université Paris Diderot, Sorbonne Paris Cité, UFR de Médecine, Paris, France</nlm:aff>
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<wicri:regionArea>Université Paris Diderot, Sorbonne Paris Cité, UFR de Médecine, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name>
<affiliation wicri:level="4"><nlm:aff id="Aff1">The George Institute for Global Health, University of Sydney, PO Box M201, Missenden road, Camperdown, Sydney, NSW 2050 Australia</nlm:aff>
<orgName type="university">Université de Sydney</orgName>
<country>Australie</country>
<placeName><settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Cardiovascular Diabetology</title>
<idno type="eISSN">1475-2840</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Amputation</term>
<term>Angioplasty</term>
<term>Diabetes Mellitus, Type 2 (complications)</term>
<term>Diabetes Mellitus, Type 2 (diagnosis)</term>
<term>Diabetes Mellitus, Type 2 (drug therapy)</term>
<term>Diabetes Mellitus, Type 2 (mortality)</term>
<term>Diabetic Angiopathies (diagnosis)</term>
<term>Diabetic Angiopathies (etiology)</term>
<term>Diabetic Angiopathies (mortality)</term>
<term>Diabetic Angiopathies (therapy)</term>
<term>Diabetic Retinopathy (etiology)</term>
<term>Female</term>
<term>Humans</term>
<term>Hypoglycemic Agents (therapeutic use)</term>
<term>Leg Ulcer (etiology)</term>
<term>Limb Salvage</term>
<term>Lower Extremity (blood supply)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Peripheral Arterial Disease (diagnosis)</term>
<term>Peripheral Arterial Disease (etiology)</term>
<term>Peripheral Arterial Disease (mortality)</term>
<term>Peripheral Arterial Disease (therapy)</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
<term>Time Factors</term>
<term>Treatment Outcome</term>
<term>Vascular Surgical Procedures</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Amputation chirurgicale</term>
<term>Angiopathies diabétiques ()</term>
<term>Angiopathies diabétiques (diagnostic)</term>
<term>Angiopathies diabétiques (mortalité)</term>
<term>Angiopathies diabétiques (étiologie)</term>
<term>Angioplastie</term>
<term>Diabète de type 2 ()</term>
<term>Diabète de type 2 (diagnostic)</term>
<term>Diabète de type 2 (mortalité)</term>
<term>Diabète de type 2 (traitement médicamenteux)</term>
<term>Facteurs de risque</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Humains</term>
<term>Hypoglycémiants (usage thérapeutique)</term>
<term>Maladie artérielle périphérique ()</term>
<term>Maladie artérielle périphérique (diagnostic)</term>
<term>Maladie artérielle périphérique (mortalité)</term>
<term>Maladie artérielle périphérique (étiologie)</term>
<term>Membre inférieur ()</term>
<term>Mâle</term>
<term>Procédures de chirurgie vasculaire</term>
<term>Résultat thérapeutique</term>
<term>Rétinopathie diabétique (étiologie)</term>
<term>Sauvetage de membre</term>
<term>Sujet âgé</term>
<term>Ulcère de la jambe (étiologie)</term>
<term>Évaluation des risques</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Hypoglycemic Agents</term>
</keywords>
<keywords scheme="MESH" qualifier="blood supply" xml:lang="en"><term>Lower Extremity</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Diabetes Mellitus, Type 2</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Diabetes Mellitus, Type 2</term>
<term>Diabetic Angiopathies</term>
<term>Peripheral Arterial Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Angiopathies diabétiques</term>
<term>Diabète de type 2</term>
<term>Maladie artérielle périphérique</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Diabetes Mellitus, Type 2</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Diabetic Angiopathies</term>
<term>Diabetic Retinopathy</term>
<term>Leg Ulcer</term>
<term>Peripheral Arterial Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Diabetes Mellitus, Type 2</term>
<term>Diabetic Angiopathies</term>
<term>Peripheral Arterial Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Angiopathies diabétiques</term>
<term>Diabète de type 2</term>
<term>Maladie artérielle périphérique</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Diabetic Angiopathies</term>
<term>Peripheral Arterial Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Diabète de type 2</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Hypoglycémiants</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Angiopathies diabétiques</term>
<term>Maladie artérielle périphérique</term>
<term>Rétinopathie diabétique</term>
<term>Ulcère de la jambe</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Amputation</term>
<term>Angioplasty</term>
<term>Female</term>
<term>Humans</term>
<term>Limb Salvage</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
<term>Time Factors</term>
<term>Treatment Outcome</term>
<term>Vascular Surgical Procedures</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Amputation chirurgicale</term>
<term>Angiopathies diabétiques</term>
<term>Angioplastie</term>
<term>Diabète de type 2</term>
<term>Facteurs de risque</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Humains</term>
<term>Maladie artérielle périphérique</term>
<term>Membre inférieur</term>
<term>Mâle</term>
<term>Procédures de chirurgie vasculaire</term>
<term>Résultat thérapeutique</term>
<term>Sauvetage de membre</term>
<term>Sujet âgé</term>
<term>Évaluation des risques</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Peripheral arterial disease (PAD) is known to be associated with high cardiovascular risk, but the individual impact of PAD presentations on risk of macrovascular and microvascular events has not been reliably compared in patients with type 2 diabetes. We aimed to evaluate the impact of major PAD, and its different presentations, on the 10-year risk of death, major macrovascular events, and major clinical microvascular events in these patients.</p>
</sec>
<sec><title>Methods</title>
<p>Participants in the action in diabetes and vascular disease: PreterAx and DiamicroN modified-release controlled evaluation (ADVANCE) trial and the ADVANCE-ON post-trial study were followed for a median of 5.0 (in-trial), 5.4 (post-trial), and 9.9 (overall) years. Major PAD at baseline was subdivided into lower-extremity chronic ulceration or amputation secondary to vascular disease and history of peripheral revascularization by angioplasty or surgery.</p>
</sec>
<sec><title>Results</title>
<p>Among 11,140 participants, 516 (4.6 %) had major PAD at baseline: 300 (2.7 %) had lower-extremity ulceration or amputation alone, 190 (1.7 %) had peripheral revascularization alone, and 26 (0.2 %) had both presentations. All-cause mortality, major macrovascular events, and major clinical microvascular events occurred in 2265 (20.3 %), 2166 (19.4 %), and 807 (7.2 %) participants, respectively. Compared to those without PAD, patients with major PAD had increased rates of all-cause mortality (HR 1.35, 95 % CI 1.15–1.60, p = 0.0004), and major macrovascular events (1.47 [1.23–1.75], p < 0.0001), after multiple adjustments for region of origin, cardiovascular risk factors and treatments, peripheral neuropathy markers, and randomized treatments. We have also observed a trend toward an association of baseline PAD with risk of major clinical microvascular events [1.31 (0.96–1.78), p = 0.09]. These associations were comparable for patients with a lower-extremity ulceration or amputation and for those with a history of peripheral revascularization. Furthermore, the risk of retinal photocoagulation or blindness, but not renal events, increased in patients with lower-extremity ulceration or amputation [1.53 (1.01–2.30), p = 0.04].</p>
</sec>
<sec><title>Conclusions</title>
<p>Lower-extremity ulceration or amputation, and peripheral revascularization both increased the risks of death and cardiovascular events, but only lower-extremity ulceration or amputation increased the risk of severe retinopathy in patients with type 2 diabetes. Screening for major PAD and its management remain crucial for cardiovascular prevention in patients with type 2 diabetes (ClinicalTrials.gov number, NCT00949286).</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s12933-016-0446-x) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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   |texte=   Presentations of major peripheral arterial disease and risk of major outcomes in patients with type 2 diabetes: results from the ADVANCE-ON study
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	Serveur d'exploration sur les relations entre la France et l'Australie
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Serveur d'exploration sur les relations entre la France et l'Australie

Presentations of major peripheral arterial disease and risk of major outcomes in patients with type 2 diabetes: results from the ADVANCE-ON study

Presentations of major peripheral arterial disease and risk of major outcomes in patients with type 2 diabetes: results from the ADVANCE-ON study

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