Sudden Cardiac Death in Patients With Type 1 Versus Type 2 Diabetes |
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| Institution: | 1. Center for Cardiac Arrest Prevention, Smidt Heart Institute, Cedars-Sinai Health System, Los Angeles, CA;2. Kaiser Permanente Center for Health Research, Portland, OR;3. Oregon Health and Science University, Portland, OR;1. Center for Digital Health, Mayo Clinic, Rochester, MN, USA;2. Department of Oncology, Mayo Clinic, Rochester, MN, USA;3. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA;4. Department of Nursing, Mayo Clinic, Rochester, MN, USA;5. Department of Medicine, Mayo Clinic, Rochester, MN, USA;6. Division of Health Care Delivery Science, Mayo Clinic, Rochester, MN, USA;7. Department of Medicine, Mayo Clinic, Scottsdale, AZ, USA;8. Department of Medicine, Mayo Clinic, Jacksonville, FL, USA;1. Division of Rheumatology, Mayo Clinic, Rochester, MN;2. Department of Dermatology, Mayo Clinic, Rochester, MN;3. Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN;4. Department of Medicine, Mayo Clinic, Rochester, MN;5. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN;6. Department of Medicine, University of Maryland Medical Center, Midtown Campus, Baltimore;7. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Atlanta, GA;1. Section of Cardiovascular Medicine, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA;2. Section of Advanced Cardiac Imaging, Division of Cardiovascular Medicine, Department of Medicine, Harbor UCLA Medical Center, Torrance, CA, USA;3. Department of Cardiovascular Medicine, NCH Heart Institute, Naples, FL, USA;4. The Carl and Edyth Lindner Center for Research and Education at the Christ Hospital Health Network, Cincinnati, OH, USA;5. Divisions of Cardiovascular Diseases and Pulmonary and Critical Care Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA;6. Section of Interventional Cardiology, Division of Cardiovascular Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA;7. Department of Cardiovascular Medicine, and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA;1. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA;2. Weill Cornell Breast Center, Department of Surgery, Weill Cornell Medicine, New York, NY, USA |
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| Abstract: | ObjectiveTo investigate the association between type 1 diabetes mellitus (T1D) and type 2 diabetes mellitus (T2D) with risk of sudden cardiac arrest (SCA).MethodsIn a prospective community-based study of SCA from February 1, 2002, through November 30, 2019, we ascertained 2771 cases age 18 years of age or older and matched them to 8313 controls based on geography, age, sex, and race/ethnicity. We used logistic regression to evaluate the independent association between diabetes, T1D, T2D, and SCA.ResultsPatients had a mean age of 64.5±15.9 years, were 33.3% female and 23.9% non-White race. Overall, 36.7% (n=1016) of cases and 23.8% (n=1981) of controls had diabetes. Among individuals with diabetes, the proportion of T1D was 6.5% (n=66) among cases and 2.0% among controls (n=40). Diabetes was associated with 1.5-times higher odds of SCA. Compared with those without diabetes, the odds ratio and 95% CI for SCA was 4.36 (95% CI, 2.81 to 6.75; P<.001) in T1D and 1.45 (95% CI, 1.30 to 1.63; P<.001) in T2D after multivariable adjustment. Among those with diabetes, the odds of having SCA were 2.41 times higher in T1D than in T2D (95% CI, 1.53 to 3.80; P<.001). Cases of SCA with T1D were more likely to have an unwitnessed arrest, less likely to receive resuscitation, and less likely to survive compared with those with T2D.ConclusionType 1 diabetes was more strongly associated with SCA compared with T2D and had less favorable outcomes following resuscitation. Diabetes type could influence the approach to risk stratification and prevention of SCA. |
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