BMJ open diabetes research & care
Impact of type 2 diabetes mellitus in patients with congenital heart disease (CHD): a study from the Australian National CHD Registry
By Lloyd L, Nicholson C, Strange G and 1 others.
Abstract
Introduction
Congenital heart disease (CHD) affects approximately 1% of live births. Advances in diagnosis and treatment have markedly improved survival, resulting in a growing adult CHD population with an increasing burden of chronic disease. Here we investigate the prevalence and impact of type 2 diabetes mellitus (T2DM) in patients with CHD. Research design and methods: Cohort study from the Australian National CHD Registry, linked to national administrative health data. Control patients without T2DM were selected from the Registry and matched 3:1 by age, sex, rurality, and CHD complexity.
Results
Of the 58 523 individuals with CHD in the registry, 2077 (3.55%) were identified as having T2DM. Median age was 43.1 (IQR 32.0–57.9) years, and 51% were female. T2DM was associated with a hazard ratio for all-cause mortality or heart transplantation of 1.51 (95% CI 1.31 to 1.73; p<0.001). 27.6% of CHD patients with T2DM experienced any major adverse cardiovascular event (MACE) versus 10.2% of controls (p<0.001). Patients with T2DM had a higher MACE rate (rate ratio 2.87, p<0.001) and had more MACE per patient (odds ratio 4.11, p<0.001) compared with controls. Individuals with T2DM also had significantly higher rates of emergency department presentations than controls (incidence rate ratio 2.35, p<0.001) and higher rates of hospital admissions (incidence rate ratio 2.87, p<0.001).