Impacts of Diabetes Mellitus on Cardiovascular Outcomes and Differential Effects of Direct Oral Anticoagulants in Patients with Left Ventricular Thrombus
Background: The focus of this investigation into the impact of type 2 diabetes mellitus (T2DM) on left ventricular thrombus (LVT) is (a) the differences in LVT characteristics, (b) long-term clinical outcomes, and (c) differential effects of direct oral anticoagulants (DOAC) among patients with T2DM...
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| Format: | Article |
| Language: | English |
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IMR Press
2023-02-01
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| Series: | Reviews in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/RCM/24/3/10.31083/j.rcm2403065 |
| _version_ | 1797861286600507392 |
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| author | Boqun Shi Rui Zhang Chenxi Song Kongyong Cui Dong Zhang Lei Jia Dong Yin Hongjian Wang Ke-Fei Dou Weihua Song |
| author_facet | Boqun Shi Rui Zhang Chenxi Song Kongyong Cui Dong Zhang Lei Jia Dong Yin Hongjian Wang Ke-Fei Dou Weihua Song |
| author_sort | Boqun Shi |
| collection | DOAJ |
| description | Background: The focus of this investigation into the impact of type 2 diabetes mellitus (T2DM) on left ventricular thrombus (LVT) is (a) the differences in LVT characteristics, (b) long-term clinical outcomes, and (c) differential effects of direct oral anticoagulants (DOAC) among patients with T2DM and without diabetes. Methods: Patients with confirmed LVT from 2009 to 2021 were included. The primary endpoints were major adverse cardiac and cerebrovascular events (MACCE), composite of cardiovascular death, ischemic stroke, and acute myocardial infarction (AMI). The secondary endpoints were all-cause death and cardiovascular death. Multivariable competing-risk regression and cumulative incidence functions (CIF) were used to evaluate the adverse consequences. Results: In total, 1675 patients were assessed initially. Follow-up data were available for 91.1% of the participants. Median follow-up was 3.8 years. This retrospective study ultimately comprised 1068 participants, of which 429 had T2DM. Significantly higher proportions of comorbidities were observed in the T2DM group. The location, morphology, and size of LVT were similar in the two groups. Multivariable analysis suggested a higher risk of MACCE among patients with T2DM. The difference in risk between the two groups after matching and weighting was not statistically significant. Among the whole sample (n = 638) or the just the non-diabetic patients with LVT and anticoagulation (n = 382), the incidence of MACCE did not differ between DOAC treatment and warfarin treatment. In the diabetic LVT population with anticoagulation (n = 256), DOAC treatment was associated with a significantly higher risk of MACCE than was warfarin treatment. Conclusions: The location and morphology of LVT are similar in T2DM and non-diabetic patients. A higher risk of MACCE was found among patients with diabetes. |
| first_indexed | 2024-04-09T21:59:48Z |
| format | Article |
| id | doaj.art-754db8a400a944db9ed567c9d12ed756 |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-04-09T21:59:48Z |
| publishDate | 2023-02-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-754db8a400a944db9ed567c9d12ed7562023-03-24T02:12:28ZengIMR PressReviews in Cardiovascular Medicine1530-65502023-02-012436510.31083/j.rcm2403065S1530-6550(22)00831-6Impacts of Diabetes Mellitus on Cardiovascular Outcomes and Differential Effects of Direct Oral Anticoagulants in Patients with Left Ventricular ThrombusBoqun Shi0Rui Zhang1Chenxi Song2Kongyong Cui3Dong Zhang4Lei Jia5Dong Yin6Hongjian Wang7Ke-Fei Dou8Weihua Song9Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 10037 Beijing, ChinaCardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 10037 Beijing, ChinaCardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 10037 Beijing, ChinaCardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 10037 Beijing, ChinaCardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 10037 Beijing, ChinaCardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 10037 Beijing, ChinaCardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 10037 Beijing, ChinaCardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 10037 Beijing, ChinaCardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 10037 Beijing, ChinaCardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 10037 Beijing, ChinaBackground: The focus of this investigation into the impact of type 2 diabetes mellitus (T2DM) on left ventricular thrombus (LVT) is (a) the differences in LVT characteristics, (b) long-term clinical outcomes, and (c) differential effects of direct oral anticoagulants (DOAC) among patients with T2DM and without diabetes. Methods: Patients with confirmed LVT from 2009 to 2021 were included. The primary endpoints were major adverse cardiac and cerebrovascular events (MACCE), composite of cardiovascular death, ischemic stroke, and acute myocardial infarction (AMI). The secondary endpoints were all-cause death and cardiovascular death. Multivariable competing-risk regression and cumulative incidence functions (CIF) were used to evaluate the adverse consequences. Results: In total, 1675 patients were assessed initially. Follow-up data were available for 91.1% of the participants. Median follow-up was 3.8 years. This retrospective study ultimately comprised 1068 participants, of which 429 had T2DM. Significantly higher proportions of comorbidities were observed in the T2DM group. The location, morphology, and size of LVT were similar in the two groups. Multivariable analysis suggested a higher risk of MACCE among patients with T2DM. The difference in risk between the two groups after matching and weighting was not statistically significant. Among the whole sample (n = 638) or the just the non-diabetic patients with LVT and anticoagulation (n = 382), the incidence of MACCE did not differ between DOAC treatment and warfarin treatment. In the diabetic LVT population with anticoagulation (n = 256), DOAC treatment was associated with a significantly higher risk of MACCE than was warfarin treatment. Conclusions: The location and morphology of LVT are similar in T2DM and non-diabetic patients. A higher risk of MACCE was found among patients with diabetes.https://www.imrpress.com/journal/RCM/24/3/10.31083/j.rcm2403065anticoagulationheart failurethrombosistype 2 diabetes |
| spellingShingle | Boqun Shi Rui Zhang Chenxi Song Kongyong Cui Dong Zhang Lei Jia Dong Yin Hongjian Wang Ke-Fei Dou Weihua Song Impacts of Diabetes Mellitus on Cardiovascular Outcomes and Differential Effects of Direct Oral Anticoagulants in Patients with Left Ventricular Thrombus Reviews in Cardiovascular Medicine anticoagulation heart failure thrombosis type 2 diabetes |
| title | Impacts of Diabetes Mellitus on Cardiovascular Outcomes and Differential Effects of Direct Oral Anticoagulants in Patients with Left Ventricular Thrombus |
| title_full | Impacts of Diabetes Mellitus on Cardiovascular Outcomes and Differential Effects of Direct Oral Anticoagulants in Patients with Left Ventricular Thrombus |
| title_fullStr | Impacts of Diabetes Mellitus on Cardiovascular Outcomes and Differential Effects of Direct Oral Anticoagulants in Patients with Left Ventricular Thrombus |
| title_full_unstemmed | Impacts of Diabetes Mellitus on Cardiovascular Outcomes and Differential Effects of Direct Oral Anticoagulants in Patients with Left Ventricular Thrombus |
| title_short | Impacts of Diabetes Mellitus on Cardiovascular Outcomes and Differential Effects of Direct Oral Anticoagulants in Patients with Left Ventricular Thrombus |
| title_sort | impacts of diabetes mellitus on cardiovascular outcomes and differential effects of direct oral anticoagulants in patients with left ventricular thrombus |
| topic | anticoagulation heart failure thrombosis type 2 diabetes |
| url | https://www.imrpress.com/journal/RCM/24/3/10.31083/j.rcm2403065 |
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