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Gender differences in screening for glucose perturbations, cardiovascular risk factor management and prognosis in patients with dysglycaemia and coronary artery disease : results from the ESC-EORP EUROASPIRE surveys

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Abstract
BackgroundGender disparities in the management of dysglycaemia, defined as either impaired glucose tolerance (IGT) or type 2 diabetes (T2DM), in coronary artery disease (CAD) patients are a medical challenge. Recent data from two nationwide cohorts of patients suggested no gender difference as regards the risk for diabetes-related CV complications but indicated the presence of a gender disparity in risk factor management. The aim of this study was to investigate gender differences in screening for dysglycaemia, cardiovascular risk factor management and prognosis in dysglycemic CAD patients.MethodsThe study population (n=16,259; 4077 women) included 7998 patients from the ESC-EORP EUROASPIRE IV (EAIV: 2012-2013, 79 centres in 24 countries) and 8261 patients from the ESC-EORP EUROASPIRE V (EAV: 2016-2017, 131 centres in 27 countries) cross-sectional surveys. In each centre, patients were investigated with standardised methods by centrally trained staff and those without known diabetes were offered an oral glucose tolerance test (OGTT). The first of CV death or hospitalisation for non-fatal myocardial infarction, stroke, heart failure or revascularization served as endpoint. Median follow-up time was 1.7 years. The association between gender and time to the occurrence of the endpoint was evaluated using Cox survival modelling, adjusting for age.ResultsKnown diabetes was more common among women (32.9%) than men (28.4%, p<0.0001). OGTT (n=8655) disclosed IGT in 17.2% of women vs. 15.1% of men (p=0.004) and diabetes in 13.4% of women vs. 14.6% of men (p=0.078). In both known diabetes and newly detected dysglycaemia groups, women were older, with higher proportions of hypertension, dyslipidaemia and obesity. HbA1c was higher in women with known diabetes. Recommended targets of physical activity, blood pressure and cholesterol were achieved by significantly lower proportions of women than men. Women with known diabetes had higher risk for the endpoint than men (age-adjusted HR 1.22; 95% CI 1.04-1.43).ConclusionsGuideline-recommended risk factor control is poorer in dysglycemic women than men. This may contribute to the worse prognosis in CAD women with known diabetes.
Keywords
Endocrinology, Diabetes and Metabolism, Cardiology and Cardiovascular Medicine, Diabetes, Coronary artery disease, Gender, Impaired glucose tolerance, Prevention

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MLA
Ferrannini, Giulia, et al. “Gender Differences in Screening for Glucose Perturbations, Cardiovascular Risk Factor Management and Prognosis in Patients with Dysglycaemia and Coronary Artery Disease : Results from the ESC-EORP EUROASPIRE Surveys.” CARDIOVASCULAR DIABETOLOGY, vol. 20, no. 1, 2021, doi:10.1186/s12933-021-01233-6.
APA
Ferrannini, G., EUROASPIRE IV & V Investigators, [missing], De Bacquer, D., Vynckier, P., De Backer, G., Gyberg, V., … Rydén, L. (2021). Gender differences in screening for glucose perturbations, cardiovascular risk factor management and prognosis in patients with dysglycaemia and coronary artery disease : results from the ESC-EORP EUROASPIRE surveys. CARDIOVASCULAR DIABETOLOGY, 20(1). https://doi.org/10.1186/s12933-021-01233-6
Chicago author-date
Ferrannini, Giulia, [missing] EUROASPIRE IV & V Investigators, Dirk De Bacquer, Pieter Vynckier, Guy De Backer, Viveca Gyberg, Kornelia Kotseva, et al. 2021. “Gender Differences in Screening for Glucose Perturbations, Cardiovascular Risk Factor Management and Prognosis in Patients with Dysglycaemia and Coronary Artery Disease : Results from the ESC-EORP EUROASPIRE Surveys.” CARDIOVASCULAR DIABETOLOGY 20 (1). https://doi.org/10.1186/s12933-021-01233-6.
Chicago author-date (all authors)
Ferrannini, Giulia, [missing] EUROASPIRE IV & V Investigators, Dirk De Bacquer, Pieter Vynckier, Guy De Backer, Viveca Gyberg, Kornelia Kotseva, Linda Mellbin, Anna Norhammar, Jaakko Tuomilehto, David Wood, and Lars Rydén. 2021. “Gender Differences in Screening for Glucose Perturbations, Cardiovascular Risk Factor Management and Prognosis in Patients with Dysglycaemia and Coronary Artery Disease : Results from the ESC-EORP EUROASPIRE Surveys.” CARDIOVASCULAR DIABETOLOGY 20 (1). doi:10.1186/s12933-021-01233-6.
Vancouver
1.
Ferrannini G, EUROASPIRE IV & V Investigators [missing], De Bacquer D, Vynckier P, De Backer G, Gyberg V, et al. Gender differences in screening for glucose perturbations, cardiovascular risk factor management and prognosis in patients with dysglycaemia and coronary artery disease : results from the ESC-EORP EUROASPIRE surveys. CARDIOVASCULAR DIABETOLOGY. 2021;20(1).
IEEE
[1]
G. Ferrannini et al., “Gender differences in screening for glucose perturbations, cardiovascular risk factor management and prognosis in patients with dysglycaemia and coronary artery disease : results from the ESC-EORP EUROASPIRE surveys,” CARDIOVASCULAR DIABETOLOGY, vol. 20, no. 1, 2021.
@article{8696864,
  abstract     = {{BackgroundGender disparities in the management of dysglycaemia, defined as either impaired glucose tolerance (IGT) or type 2 diabetes (T2DM), in coronary artery disease (CAD) patients are a medical challenge. Recent data from two nationwide cohorts of patients suggested no gender difference as regards the risk for diabetes-related CV complications but indicated the presence of a gender disparity in risk factor management. The aim of this study was to investigate gender differences in screening for dysglycaemia, cardiovascular risk factor management and prognosis in dysglycemic CAD patients.MethodsThe study population (n=16,259; 4077 women) included 7998 patients from the ESC-EORP EUROASPIRE IV (EAIV: 2012-2013, 79 centres in 24 countries) and 8261 patients from the ESC-EORP EUROASPIRE V (EAV: 2016-2017, 131 centres in 27 countries) cross-sectional surveys. In each centre, patients were investigated with standardised methods by centrally trained staff and those without known diabetes were offered an oral glucose tolerance test (OGTT). The first of CV death or hospitalisation for non-fatal myocardial infarction, stroke, heart failure or revascularization served as endpoint. Median follow-up time was 1.7 years. The association between gender and time to the occurrence of the endpoint was evaluated using Cox survival modelling, adjusting for age.ResultsKnown diabetes was more common among women (32.9%) than men (28.4%, p<0.0001). OGTT (n=8655) disclosed IGT in 17.2% of women vs. 15.1% of men (p=0.004) and diabetes in 13.4% of women vs. 14.6% of men (p=0.078). In both known diabetes and newly detected dysglycaemia groups, women were older, with higher proportions of hypertension, dyslipidaemia and obesity. HbA1c was higher in women with known diabetes. Recommended targets of physical activity, blood pressure and cholesterol were achieved by significantly lower proportions of women than men. Women with known diabetes had higher risk for the endpoint than men (age-adjusted HR 1.22; 95% CI 1.04-1.43).ConclusionsGuideline-recommended risk factor control is poorer in dysglycemic women than men. This may contribute to the worse prognosis in CAD women with known diabetes.}},
  articleno    = {{38}},
  author       = {{Ferrannini, Giulia and EUROASPIRE IV & V Investigators, [missing] and De Bacquer, Dirk and Vynckier, Pieter and De Backer, Guy and Gyberg, Viveca and Kotseva, Kornelia and Mellbin, Linda and Norhammar, Anna and Tuomilehto, Jaakko and Wood, David and Rydén, Lars}},
  issn         = {{1475-2840}},
  journal      = {{CARDIOVASCULAR DIABETOLOGY}},
  keywords     = {{Endocrinology,Diabetes and Metabolism,Cardiology and Cardiovascular Medicine,Diabetes,Coronary artery disease,Gender,Impaired glucose tolerance,Prevention}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{12}},
  title        = {{Gender differences in screening for glucose perturbations, cardiovascular risk factor management and prognosis in patients with dysglycaemia and coronary artery disease : results from the ESC-EORP EUROASPIRE surveys}},
  url          = {{http://doi.org/10.1186/s12933-021-01233-6}},
  volume       = {{20}},
  year         = {{2021}},
}

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