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Incidence and prognosis of heart failure in persons with type 2 diabetes compared with individuals without diabetes - a nation-wide study from Finland in 1996-2012.

ABSTRACT: Aims: To quantify the incidence and prevalence of heart failure (HF) in persons with type 2 diabetes (T2DM) and to examine the 1-year survival after the diagnosis of HF. Materials and methods: All cases of HF (n?=?295,990) and T2DM in Finland were identified from national electronic health care registers for the period 1996-2012. The annual incidence and prevalence rates of HF and 1-year survival after the first diagnosis of HF were calculated for persons with T2DM and without diabetes using Poisson regression for the event rates. Results: The age-adjusted rate ratio for incident HF among men with T2DM in the age group 35-74 years declined from 3.73 (95% CI, 3.46-4.02) in 1996 to 2.17 (2.04-2.31) in 2012 and among women from 3.90 (3.61-4.22) to 2.36 (2.16-2.58). The multivariate-adjusted hazard ratio of 1-year death after the diagnosis of HF declined from 1.15 (1.11-1.21) to 1.07 (1.05-1.10) from the first to the second half of the study period. Conclusions: Individuals aged <75 years with T2DM had a considerably higher incidence of HF than individuals without diabetes. The prognosis of HF was worse in individuals with T2DM than in individuals without diabetes. However, the gap between the groups had narrowed over time. Key messages The incidence of heart failure is 2-3 times higher among patients under 75 years of age with type 2 diabetes than among individuals without diabetes. The prognosis of heart failure patients is worse among patients with type 2 diabetes than it is among patients without diabetes although it is improving.

SUBMITTER: Winell K

PROVIDER: S-EPMC7857487 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Incidence and prognosis of heart failure in persons with type 2 diabetes compared with individuals without diabetes - a nation-wide study from Finland in 1996-2012.

Winell Klas K Pietilä Arto A Salomaa Veikko V

Annals of medicine 20190301 2

Aims: To quantify the incidence and prevalence of heart failure (HF) in persons with type 2 diabetes (T2DM) and to examine the 1-year survival after the diagnosis of HF. Materials and methods: All cases of HF (n = 295,990) and T2DM in Finland were identified from national electronic health care registers for the period 1996-2012. The annual incidence and prevalence rates of HF and 1-year survival after the first diagnosis of HF were calculated for persons with T2DM and witho ...[more]

PMID: 31055965

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Project description:ImportanceThe association between income and mental health has long been a question of interest. Nationwide register data provide means to examine trends and patterns of these associations.ObjectivesTo compare income-specific trends in the incidence rates of first psychiatric hospital admissions and to evaluate whether an income gradient exists in the incidence rates at all levels of household income.Design, setting, and participantsThis population-based open cohort study used linked registry data from nationwide Finnish Hospital Discharge and Statistics Finland population registers to determine annual incidence rates of first psychiatric hospital admissions. All Finnish citizens (N = 6 258 033) living in the country at any time from January 1, 1996, through December 31, 2014, contributed to 96 184 614 person-years at risk of first inpatient treatment for mental disorders. The analyses were conducted from August 1, 2018, through September 30, 2019.ExposuresEquivalized disposable income, sex, age group, reduction in income decile in the previous 3 years, urbanicity, educational level, and living alone status.Main outcomes and measuresAnnual percentage changes in the age-standardized incidence rates and incidence rate ratios (IRRs).ResultsAltogether, 186 082 first psychiatric inpatient treatment episodes occurred (93 431 [50.2%] men), with overall age-standardized incidence rates per 1000 person-years varying from 1.59 (95% CI, 1.56-1.63) in 2014 to 2.11 (95% CI, 2.07-2.15) in 2008. In the highest income deciles, a continuous mean decrease per year of 3.71% (95% CI, 2.82%-4.59%) in men and 0.91% (95% CI, 0.01%-1.80%) in women occurred throughout the study period, in contrast to the lowest deciles, where the trends first increased (1.31% [95% CI, 0.62%-2.01%] increase in men from 1996 to 2007 and 5.61% [95% CI, 2.36%-8.96%] increase in women from 1996 to 2001). In the adult population, an income gradient was observed at all levels of household income: the lower the income decile, the higher the adjusted IRRs compared with the highest decile. The IRRs in the lowest decile varied from 2.94 (95% CI, 2.78-3.11) to 4.46 (95% CI, 4.17-4.76). In other age groups, the gradient did not persist at the highest income deciles. Diagnosis-specific income gradient was steepest in schizophrenia and related psychotic disorders, with estimated IRRs of the lowest income decile of 5.89 (95% CI, 5.77-6.02).Conclusions and relevanceIn this cohort study, clear negative income gradient in the incidence rates of first hospital-treated mental disorders was observed in the adult population of Finland. These findings suggest that reduction in the use of inpatient care has not taken place equally between different income groups.

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Incidence and prognosis of heart failure in persons with type 2 diabetes compared with individuals without diabetes - a nation-wide study from Finland in 1996-2012.

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Incidence and prognosis of heart failure in persons with type 2 diabetes compared with individuals without diabetes - a nation-wide study from Finland in 1996-2012.

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