The risk of infective endocarditis according to blood pressure in patients with diabetes: a nationwide population-based study
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
We aimed to assess the incidence of infective endocarditis (IE) and evaluate the impact of hypertension (HTN) with underweight on the risk of IE among patients with diabetic mellitus (DM) using a nationwide population-based cohort in Korea.We identified 2,603,012 participants (57.4 ± 12.3 years) in the national health insurance database. Of these, 374,586 were normotensive, 750,006 were at pre-HTN status, and the remainder had HTN. The risk of IE was compared between the groups, and the impact of being underweight (body mass index < 18.5) was also evaluated.During follow-up (7.14 years; interquartile range 6.01–8.08 years), 1,703 cases of IE occurred; 168 (0.0647 person per 1000 person-years [PY]), 303 (0.05836 per 1000 PY), and 1,232 (0.12235 per 1000 PY) in normotensive, pre-HTN and HTN group, respectively. Hypertensive participants presented a higher risk of IE (subdistribution hazard ratio, 1.360; 95% confidence interval, 1.152–1.607) than normotensive participants. Being underweight increased the risk of IE by 90% among subjects with HTN. In subgroup analysis, age, duration of DM, insulin use, and habitual factors were not associated with the incidence of IE.Diabetic patients may require rigorous blood pressure control and simultaneous avoidance of excessive weight loss to prevent IE.
Abstract
Background We aimed to assess the incidence of infective endocarditis (IE) and evaluate the impact of hypertension (HTN) with underweight on the risk of IE among patients with diabetic mellitus (DM) using a nationwide populationbased cohort in Korea. Methods We identified 2,603,012 participants (57.4±12.3 years) in the national health insurance database. Of these, 374,586 were normotensive, 750,006 were at pre-HTN status, and the remainder had HTN. The risk of IE was compared between the groups, and the impact of being underweight (body mass index<18.5) was also evaluated. Results During follow-up (7.14 years; interquartile range 6.01–8.08 years), 1,703 cases of IE occurred; 168 (0.0647 person per 1000 person-years [PY]), 303 (0.05836 per 1000 PY), and 1,232 (0.12235 per 1000 PY) in normotensive, preHTN and HTN group, respectively. Hypertensive participants presented a higher risk of IE (subdistribution hazard ratio, 1.360; 95% confidence interval, 1.152–1.607) than normotensive participants. Being underweight increased the risk of IE by 90% among subjects with HTN. In subgroup analysis, age, duration of DM, insulin use, and habitual factors were not associated with the incidence of IE. Conclusions Diabetic patients may require rigorous blood pressure control and simultaneous avoidance of excessive weight loss to prevent IE.
참고문헌 (24)
- Talha KM, "Escalating incidence of infective endocarditis in Europe in the 21st century", Open Heart, 8(2) (2021)
- Murdoch DR, "Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the international collaboration on endocarditis-prospective cohort study", Arch Intern Med, 169(5), pp.463~473 (2009)
- Pant S, "Trends in infective endocarditis incidence, microbiology, and valve replacement in the United States from 2000 to 2011", J Am Coll Cardiol, 65(19), pp.2070~2076 (2015)
- Cahill TJ, "Risk of infective endocarditis after surgical and transcatheter aortic valve replacement", Heart, 108(8), pp.639~647 (2022)
- Kim JY, "Risk of infective endocarditis associated with invasive dental procedures in patients with cardiac rhythm devices", Europace, 24(12), pp.1967~1972 (2022)
- Østergaard L, "Incidence of infective endocarditis in patients considered at moderate risk", Eur Heart J, 40(17), pp.1355~1361 (2019)
- Kim EJ, "Diabetes and the risk of infection : a National Cohort Study", Diabetes Metab J, 43(6), pp.804~814 (2019)
- de Miguel-Yanes JM, "Infective endocarditis according to type 2 diabetes mellitus status : an observational study in Spain, 2001–2015", Cardiovasc Diabetol, 18(1), pp.161~ (2019)
- Tomic D, "The burden and risks of emerging complications of diabetes mellitus", Nat Rev Endocrinol, 18(9), pp.525~539 (2022)
- Casqueiro J, "Infections in patients with diabetes mellitus : a review of pathogenesis", Indian J Endocrinol Metab, 16(Suppl 1Suppl1), pp.S27~S36 (2012)
- Dobner J, "Body mass index and the risk of infection-from underweight to obesity", Clin Microbiol Infect, 24(1), pp.24~28 (2018)
- Lee GB, "Association between Hypertension and Incident Infective Endocarditis", Hypertension, 79(7), pp.1466~1474 (2022)
- Higgins H, "Estimating the Population benefits of blood pressure lowering : a wide-angled mendelian randomization study in UK Biobank", J Am Heart Association, 10(17), pp.e021098~ (2021)
- Gribsholt SB, "Body Mass Index and 90-Day Mortality Among 35, 406 Danish Patients Hospitalized for Infection", Mayo Clin Proc, 96(3), pp.550~ (2021)
- Rios-Diaz AJ, "The obesity paradox in patients with severe soft tissue infections", Am J Surg, 214(3), pp.385~389 (2017)
- Nie W, "Obesity survival paradox in pneumonia : a meta-analysis", BMC Med, 12, pp.61~ (2014)
- Carey IM, "Risk of infection in type 1 and type 2 diabetes compared with the General Population : a matched cohort study", Diabetes Care, 41(3), pp.513~521 (2018)
- Lu P, "Association of BMI, diabetes, and risk of tuberculosis : a population-based prospective cohort", Int J Infect Dis, 109, pp.168~173 (2021)
- Østergaard L, "Duration and complications of diabetes mellitus and the associated risk of infective endocarditis", Int J Cardiol, 278, pp.280~284 (2019)
- Nazarzadeh M, "Systolic blood pressure and risk of Valvular Heart Disease : a mendelian randomization study", JAMA Cardiol, 4(8), pp.788~795 (2019)
- Kalra SS, "Vascular calcification and hypertension : cause and effect", Ann Med, 44(Suppl 1), pp.S85~S92 (2012)
- Sitia S, "From endothelial dysfunction to atherosclerosis", Autoimmun Rev, 9(12), pp.830~834 (2010)
- Doehner W, "Inverse relation of body weight and weight change with mortality and morbidity in patients with type 2 diabetes and cardiovascular co-morbidity : an analysis of the PROactive study population", Int J Cardiol, 162(1), pp.20~26 (2012)
- Wiebe N, "Associations of body mass index, fasting insulin, and inflammation with mortality : a prospective cohort study", Int J Obes(Lond), 46(12), pp.2107~2113 (2022)