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Sex differences in management and outcomes of patients with type 2 diabetes and cardiovascular disease: A report from TECOS.

Publication ,  Journal Article
Alfredsson, J; Green, JB; Stevens, SR; Reed, SD; Armstrong, PW; Angelyn Bethel, M; Engel, SS; McGuire, DK; Van de Werf, F; Hramiak, I ...
Published in: Diabetes Obes Metab
October 2018

AIM: To examine sex differences in baseline characteristics and outcomes in patients with type 2 diabetes and atherosclerotic vascular disease. MATERIALS AND METHODS: Cox models were used to analyse the association between sex and outcomes in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS), a randomized, placebo-controlled trial assessing the impact of sitagliptin on cardiovascular (CV) outcomes in patients with type 2 diabetes and atherosclerotic vascular disease. RESULTS: A total of 4297 women and 10 374 men were followed for a median of 3.0 years. Women were slightly older and more often had cerebrovascular disease and peripheral arterial disease but less often coronary heart disease than men. At baseline, women were less likely to use aspirin or statins. The primary composite outcome of CV death, myocardial infarction, stroke, or hospitalization for unstable angina occurred in 418 women (9.7%) and 1272 men (12.3%; 3.48 vs 4.38 events/100 participant-years, crude hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.71-0.89, adjusted HR 0.64, 95% CI 0.55-0.74; P < .0001). Women also had a significantly lower risk of secondary CV outcomes and all-cause death. CONCLUSIONS: In this large prospective study of people with type 2 diabetes and CV disease, women had different CV disease burden, worse CV risk factor profiles, and less use of indicated medications than men. Despite this, women had significantly lower risk of CV events, suggesting that the cardioprotective effects of female sex extend to populations with type 2 diabetes.

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Published In

Diabetes Obes Metab

DOI

EISSN

1463-1326

Publication Date

October 2018

Volume

20

Issue

10

Start / End Page

2379 / 2388

Location

England

Related Subject Headings

  • Treatment Outcome
  • Sitagliptin Phosphate
  • Sex Factors
  • Risk Factors
  • Middle Aged
  • Male
  • Hypoglycemic Agents
  • Humans
  • Hospitalization
  • Follow-Up Studies
 

Citation

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Alfredsson, J., Green, J. B., Stevens, S. R., Reed, S. D., Armstrong, P. W., Angelyn Bethel, M., … TECOS Study Group, . (2018). Sex differences in management and outcomes of patients with type 2 diabetes and cardiovascular disease: A report from TECOS. Diabetes Obes Metab, 20(10), 2379–2388. https://doi.org/10.1111/dom.13377
Alfredsson, Joakim, Jennifer B. Green, Susanna R. Stevens, Shelby D. Reed, Paul W. Armstrong, M. Angelyn Bethel, Samuel S. Engel, et al. “Sex differences in management and outcomes of patients with type 2 diabetes and cardiovascular disease: A report from TECOS.Diabetes Obes Metab 20, no. 10 (October 2018): 2379–88. https://doi.org/10.1111/dom.13377.
Alfredsson J, Green JB, Stevens SR, Reed SD, Armstrong PW, Angelyn Bethel M, et al. Sex differences in management and outcomes of patients with type 2 diabetes and cardiovascular disease: A report from TECOS. Diabetes Obes Metab. 2018 Oct;20(10):2379–88.
Alfredsson, Joakim, et al. “Sex differences in management and outcomes of patients with type 2 diabetes and cardiovascular disease: A report from TECOS.Diabetes Obes Metab, vol. 20, no. 10, Oct. 2018, pp. 2379–88. Pubmed, doi:10.1111/dom.13377.
Alfredsson J, Green JB, Stevens SR, Reed SD, Armstrong PW, Angelyn Bethel M, Engel SS, McGuire DK, Van de Werf F, Hramiak I, White HD, Peterson ED, Holman RR, TECOS Study Group. Sex differences in management and outcomes of patients with type 2 diabetes and cardiovascular disease: A report from TECOS. Diabetes Obes Metab. 2018 Oct;20(10):2379–2388.
Journal cover image

Published In

Diabetes Obes Metab

DOI

EISSN

1463-1326

Publication Date

October 2018

Volume

20

Issue

10

Start / End Page

2379 / 2388

Location

England

Related Subject Headings

  • Treatment Outcome
  • Sitagliptin Phosphate
  • Sex Factors
  • Risk Factors
  • Middle Aged
  • Male
  • Hypoglycemic Agents
  • Humans
  • Hospitalization
  • Follow-Up Studies