Table 3.
CV mortality rates per 1000 person-years among the DKD and comparison cohorts, and associated HRs (95% CIs; DKD vs comparison)
| Variable | CV deaths | Incidence rate per 1000 person-years | HR* (95% CI) |
P value | SHR* (95% CI) |
P value |
| Subcohort | ||||||
| Matched comparison | 103 | 3.65 | 1.0 (reference) | 1.0 (reference) | ||
| DKD | 233 | 8.00 | 1.60 (1.24 to 2.05) | <0.01 | 1.56 (1.21 to 2.00) | <0.01 |
| Age (years) | ||||||
| <40 | 0 | – | – | – | – | – |
| 40–49 | 4 | 0.85 | 1.0 (reference) | 1.0 (reference) | ||
| 50–64 | 48 | 2.62 | 2.29 (0.82 to 6.42) | 0.12 | 2.18 (0.78 to 6.05) | 0.14 |
| 65–74 | 102 | 5.20 | 3.68 (1.31 to 10.30) | 0.01 | 3.32 (1.19 to 9.24) | 0.02 |
| 75–89 | 182 | 13.34 | 7.78 (2.75 to 21.99) | <0.01 | 6.24 (2.26 to 17.23) | <0.01 |
| Sex | ||||||
| Male | 213 | 6.00 | 1.0 (reference) | 1.0 (reference) | ||
| Female | 123 | 5.62 | 0.89 (0.69 to 1.13) | 0.33 | 0.91 (0.71 to 1.15) | 0.42 |
| Smoking | ||||||
| Non-smoker | 88 | 4.42 | 1.0 (reference) | 1.0 (reference) | ||
| Smoker | 38 | 5.08 | 1.31 (0.88 to 1.96) | 0.19 | 1.18 (0.79 to 1.77) | 0.42 |
| Ex–smoker | 164 | 5.85 | 0.95 (0.72 to 1.25) | 0.72 | 0.98 (0.74 to 1.30) | 0.89 |
| Missing | 46 | 24.20 | 4.98 (3.40 to 7.30) | <0.01 | 2.14 (1.47 to 3.13) | <0.01 |
| Alcohol (units/week) | ||||||
| Non-drinker | 72 | 5.83 | 1.0 (reference) | 1.0 (reference) | ||
| 1–2 | 108 | 5.96 | 1.09 (0.80 to 1.48) | 0.59 | 1.11 (0.82 to 1.52) | 0.50 |
| 3–15 | 89 | 6.05 | 1.25 (0.90 to 1.73) | 0.19 | 1.22 (0.87 to 1.70) | 0.25 |
| 16–24 | 16 | 4.98 | 1.12 (0.64 to 1.97) | 0.69 | 1.13 (0.63 to 2.01) | 0.69 |
| ≥25 | 19 | 5.11 | 1.18 (0.69 to 2.00) | 0.54 | 1.13 (0.66 to 1.93) | 0.65 |
| Missing | 32 | 6.08 | 1.18 (0.77 to 1.80) | 0.44 | 1.14 (0.74 to 1.76) | 0.56 |
| BMI (kg/m2) | ||||||
| <20 | 10 | 13.70 | 1.55 (0.77 to 3.09) | 0.22 | 1.37 (0.67 to 2.82) | 0.39 |
| 20–24 | 48 | 6.59 | 1.0 (reference) | 1.0 (reference) | ||
| 25–29 | 121 | 6.16 | 1.09 (0.78 to 1.54) | 0.61 | 1.20 (0.85 to 1.70) | 0.30 |
| ≥30 | 153 | 5.22 | 1.13 (0.80 to 1.59) | 0.49 | 1.25 (0.88 to 1.78) | 0.22 |
| Missing | 4 | 10.98 | 1.84 (0.65 to 5.19) | 0.25 | 1.47 (0.50 to 4.39) | 0.48 |
| Townsend index | ||||||
| 1st quintile (least deprivation) | 51 | 4.43 | 1.0 (reference) | 1.0 (reference) | ||
| 2nd quintile | 71 | 6.13 | 1.28 (0.89 to 1.83) | 0.19 | 1.28 (0.89 to 1.84) | 0.19 |
| 3rd quintile | 74 | 6.07 | 1.32 (0.92 to 1.89) | 0.13 | 1.30 (0.90 to 1.88) | 0.16 |
| 4th quintile | 73 | 6.19 | 1.31 (0.91 to 1.89) | 0.15 | 1.32 (0.92 to 1.91) | 0.13 |
| 5th quintile (most deprivation) | 61 | 6.90 | 1.48 (1.01 to 2.18) | 0.04 | 1.50 (1.02 to 2.21) | 0.04 |
| Missing | 6 | 4.21 | 0.84 (0.36 to 1.98) | 0.69 | 0.84 (0.35 to 1.97) | 0.68 |
| Glycemic control quality† | ||||||
| Always ≤8% | 216 | 5.98 | 1.0 (reference) | 1.0 (reference) | ||
| At some point >8% | 85 | 6.07 | 1.27 (0.98 to 1.65) | 0.07 | 1.24 (0.95 to 1.62) | 0.11 |
| Missing | 35 | 4.84 | 0.86 (0.59 to 1.26) | 0.44 | 0.87 (0.59 to 1.27) | 0.47 |
| Comorbidities | ||||||
| Hypertension | 266 | 6.79 | 1.36 (1.02 to 1.81) | 0.03 | 1.36 (1.03 to 1.81) | 0.03 |
| Hyperlipemia | 120 | 6.26 | 1.00 (0.79 to 1.25) | 0.97 | 1.02 (0.81 to 1.29) | 0.86 |
| Heart failure | 68 | 26.43 | 1.56 (1.11 to 2.19) | 0.01 | 1.46 (1.00 to 2.14) | 0.05 |
| IHD | 124 | 10.89 | 1.30 (1.02 to 1.65) | 0.04 | 1.26 (0.97 to 1.62) | 0.08 |
| Atrial fibrillation | 100 | 21.59 | 1.85 (1.40 to 2.45) | <0.01 | 1.79 (1.33 to 2.41) | <0.01 |
| Cerebrovascular disease | 69 | 14.21 | 1.55 (1.18 to 2.05) | <0.01 | 1.51 (1.14 to 2.00) | <0.01 |
| COPD | 52 | 12.53 | 1.54 (1.13 to 2.11) | 0.01 | 1.26 (0.91 to 1.74) | 0.17 |
| Peptic ulcer disease | 37 | 9.20 | 1.06 (0.75 to 1.51) | 0.73 | 1.08 (0.75 to 1.55) | 0.70 |
| Pancreatic disease | 9 | 10.26 | 1.31 (0.66 to 2.58) | 0.44 | 1.31 (0.64 to 2.70) | 0.46 |
| Liver disorders | 12 | 5.79 | 0.90 (0.50 to 1.62) | 0.73 | 0.83 (0.46 to 1.51) | 0.55 |
| Cancer | 66 | 8.94 | 1.15 (0.87 to 1.52) | 0.32 | 1.02 (0.76 to 1.36) | 0.92 |
| GP visits† | ||||||
| <12 | 40 | 2.92 | 1.0 (reference) | 1.0 (reference) | ||
| 12–23 | 135 | 4.84 | 1.40 (0.98 to 2.01) | 0.07 | 1.35 (0.95 to 1.93) | 0.10 |
| 24–35 | 82 | 7.70 | 1.54 (1.02 to 2.31) | 0.04 | 1.52 (1.00 to 2.29) | 0.05 |
| ≥36 | 79 | 15.44 | 2.20 (1.40 to 3.47) | <0.01 | 1.80 (1.12 to 2.89) | 0.01 |
| Referrals to secondary care† | ||||||
| None | 43 | 4.63 | 1.0 (reference) | 1.0 (reference) | ||
| 1–6 | 191 | 5.42 | 1.03 (0.73 to 1.44) | 0.88 | 1.03 (0.73 to 1.45) | 0.87 |
| ≥7 | 102 | 7.94 | 0.83 (0.55 to 1.25) | 0.38 | 0.83 (0.55 to 1.26) | 0.38 |
| >1 hospitalization† | 94 | 10.10 | 1.23 (0.94 to 1.61) | 0.14 | 1.14 (0.86 to 1.52) | 0.35 |
| Lowest eGFR (mL/min/1.73 m2)† | ||||||
| ≥90 | 16 | 1.47 | 1.0 (reference) | 1.0 (reference) | ||
| 60–89 | 130 | 4.94 | 1.57 (0.91 to 2.72) | 0.10 | 1.62 (0.93 to 2.83) | 0.09 |
| 45–59 | 104 | 9.55 | 1.81 (1.02 to 3.20) | 0.04 | 1.91 (1.07 to 3.42) | 0.03 |
| 30–44 | 46 | 15.37 | 2.07 (1.11 to 3.87) | 0.02 | 1.99 (1.04 to 3.80) | 0.04 |
| 15–29 | 14 | 19.59 | 2.63 (1.22 to 5.65) | 0.01 | 2.10 (0.93 to 4.72) | 0.07 |
| <15 | 0 | 0 | – | – | ||
| Missing | 26 | 4.80 | 1.81 (0.94 to 3.49) | 0.08 | 1.80 (0.93 to 3.49) | 0.08 |
| Medication use† | ||||||
| ACEI/ARB | 253 | 6.47 | 0.88 (0.67 to 1.16) | 0.36 | 0.88 (0.67 to 1.16) | 0.36 |
| MRA | 39 | 32.79 | 2.10 (1.40 to 3.13) | <0.01 | 2.07 (1.33 to 3.22) | <0.01 |
*Adjusted for all the other variables in the table.
†In the year before study entry.
ACEI, ACE inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; COPD, chronic obstructive pulmonary disease; CV, cardiovascular; DKD, diabetic kidney disease; eGFR, estimated glomerular filtration rate; GP, general practitioner; IHD, ischemic heart disease; MRA, mineralocorticoid receptor antagonist; SHR, subdistribution HR.