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Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015

BACKGROUND: The main aims of this study were to describe trends and outcomes during admission for infective endocarditis (IE) in people ≥ 40 years old with or without type 2 diabetes distributed in five time-periods (2001–2003; 2004–2006; 2007–2009; 2010–2012 and 2013–2015), using Spanish national h...

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Autores principales: de Miguel-Yanes, José M., Jiménez-García, Rodrigo, Hernández-Barrera, Valentín, de Miguel-Díez, Javier, Méndez-Bailón, Manuel, Muñoz-Rivas, Nuria, Pérez-Farinós, Napoleón, López-de-Andrés, Ana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6868776/
https://www.ncbi.nlm.nih.gov/pubmed/31752887
http://dx.doi.org/10.1186/s12933-019-0968-0
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author de Miguel-Yanes, José M.
Jiménez-García, Rodrigo
Hernández-Barrera, Valentín
de Miguel-Díez, Javier
Méndez-Bailón, Manuel
Muñoz-Rivas, Nuria
Pérez-Farinós, Napoleón
López-de-Andrés, Ana
author_facet de Miguel-Yanes, José M.
Jiménez-García, Rodrigo
Hernández-Barrera, Valentín
de Miguel-Díez, Javier
Méndez-Bailón, Manuel
Muñoz-Rivas, Nuria
Pérez-Farinós, Napoleón
López-de-Andrés, Ana
author_sort de Miguel-Yanes, José M.
collection PubMed
description BACKGROUND: The main aims of this study were to describe trends and outcomes during admission for infective endocarditis (IE) in people ≥ 40 years old with or without type 2 diabetes distributed in five time-periods (2001–2003; 2004–2006; 2007–2009; 2010–2012 and 2013–2015), using Spanish national hospital discharge data. METHODS: We estimated admission rates by diabetes status. We analyzed comorbidity, therapeutic procedures, and outcomes. We built Poisson regression models to compare the adjusted time-trends in admission rates. Type 2 diabetes cases were matched with controls using propensity score matching (PSM). We tested in-hospital mortality (IHM) in logistic regression analyses. RESULTS: We identified 16,626 hospitalizations in patients aged ≥ 40 years for IE in Spain, 2001–2015. The incidence of IE increased significantly from 6.0/100,000 per year to 13.1/100,000 per year (p < 0.001) in the population with type 2 diabetes, and from 3.9/100,000 per year to 5.5/100,000 per year (p < 0.001) in the population without diabetes, over the study period. The adjusted incidence of IE was 2.2-times higher among patients with diabetes than among those without diabetes (IRR = 2.2; 95% CI 2.1–2.3). People with type 2 diabetes less often underwent heart valve surgery than people without diabetes (13.9% vs. 17.3%; p < 0.001). Although IHM decreased significantly in both groups over time, it represented 20.8% of IE cases among diabetes patients and 19.9% among PSM matched controls (p = 0.337). Type 2 diabetes was not associated with a higher IHM in people admitted to the hospital for IE (OR = 1.1; 95% CI 0.9–1.2). CONCLUSION: Incidence rates of IE in Spain, among those with and without T2DM, have increased during the period 2001–2015 with significantly higher incidence rates in the T2DM population. In our population based study and after PSM we found that T2DM was not a predictor of IHM in IE.
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spelling pubmed-68687762019-12-12 Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015 de Miguel-Yanes, José M. Jiménez-García, Rodrigo Hernández-Barrera, Valentín de Miguel-Díez, Javier Méndez-Bailón, Manuel Muñoz-Rivas, Nuria Pérez-Farinós, Napoleón López-de-Andrés, Ana Cardiovasc Diabetol Original Investigation BACKGROUND: The main aims of this study were to describe trends and outcomes during admission for infective endocarditis (IE) in people ≥ 40 years old with or without type 2 diabetes distributed in five time-periods (2001–2003; 2004–2006; 2007–2009; 2010–2012 and 2013–2015), using Spanish national hospital discharge data. METHODS: We estimated admission rates by diabetes status. We analyzed comorbidity, therapeutic procedures, and outcomes. We built Poisson regression models to compare the adjusted time-trends in admission rates. Type 2 diabetes cases were matched with controls using propensity score matching (PSM). We tested in-hospital mortality (IHM) in logistic regression analyses. RESULTS: We identified 16,626 hospitalizations in patients aged ≥ 40 years for IE in Spain, 2001–2015. The incidence of IE increased significantly from 6.0/100,000 per year to 13.1/100,000 per year (p < 0.001) in the population with type 2 diabetes, and from 3.9/100,000 per year to 5.5/100,000 per year (p < 0.001) in the population without diabetes, over the study period. The adjusted incidence of IE was 2.2-times higher among patients with diabetes than among those without diabetes (IRR = 2.2; 95% CI 2.1–2.3). People with type 2 diabetes less often underwent heart valve surgery than people without diabetes (13.9% vs. 17.3%; p < 0.001). Although IHM decreased significantly in both groups over time, it represented 20.8% of IE cases among diabetes patients and 19.9% among PSM matched controls (p = 0.337). Type 2 diabetes was not associated with a higher IHM in people admitted to the hospital for IE (OR = 1.1; 95% CI 0.9–1.2). CONCLUSION: Incidence rates of IE in Spain, among those with and without T2DM, have increased during the period 2001–2015 with significantly higher incidence rates in the T2DM population. In our population based study and after PSM we found that T2DM was not a predictor of IHM in IE. BioMed Central 2019-11-21 /pmc/articles/PMC6868776/ /pubmed/31752887 http://dx.doi.org/10.1186/s12933-019-0968-0 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Investigation
de Miguel-Yanes, José M.
Jiménez-García, Rodrigo
Hernández-Barrera, Valentín
de Miguel-Díez, Javier
Méndez-Bailón, Manuel
Muñoz-Rivas, Nuria
Pérez-Farinós, Napoleón
López-de-Andrés, Ana
Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015
title Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015
title_full Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015
title_fullStr Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015
title_full_unstemmed Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015
title_short Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015
title_sort infective endocarditis according to type 2 diabetes mellitus status: an observational study in spain, 2001–2015
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6868776/
https://www.ncbi.nlm.nih.gov/pubmed/31752887
http://dx.doi.org/10.1186/s12933-019-0968-0
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