2型糖尿病患者心血管结果和成本的时间趋势
Brent A Williams1, Jigar Rajpura2, Yurek M Paprocki2
1Allegheny Health Network, Pittsburgh, PA.
American heart journal
|July 29, 2023
概括
2型糖尿病 (T2D) 的心血管疾病结局通常有所改善,但年轻患者和缺血性中风的趋势恶化. 医疗保健费用用于药物和紧急诊所的费用大幅增加.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 2型糖尿病 (T2D) 是心血管疾病 (CV) 的重要危险因素.
- 虽然T2D的CV结果在历史上有所改善,但最近的美国数据显示,老年人进展放缓,年轻人趋势恶化.
- 关于T2D中CV结果的现有数据只有到2015年才能获得.
研究的目的:
- 分析2001年至2018年2型糖尿病患者中CV结果的时间趋势.
- 评估同一时期与T2D管理相关的医疗保健成本的变化.
主要方法:
- 使用区域医疗保险数据的回顾性队列研究.
- 评估结果包括急性心肌梗塞 (AMI),缺血性中风,出血性中风,心力衰竭住院治疗 (HFH),皮肤冠状动脉干预,冠状动脉旁路手术和全因死亡率.
- 普森回归被用来估计17年研究期间的利率比率.
主要成果:
- 在79,392名T2D患者中,AMI,HFH和全因死亡率的趋势有所改善,但缺血性中风的趋势恶化.
- 与年轻人相比,老年人群中AMI,HFH和死亡率的改善更为明显.
- 医疗保健费用增加,药品和急诊室的访问显示了加快的年度增长率.
结论:
- 在T2D中,大多数心血管结局呈现改善,但年轻患者的进展或恶化趋势较小.
- 与T2D相关的医疗保健支出加速增加,特别是用于药物和急诊室使用.
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