Associations of Clinical Characteristics With Sudden Cardiac Arrest in People With Type 2 Diabetes With and Without Cardiovascular Disease: A Longitudinal Case-Control Study Using Routine Primary Care Data
Authors' conclusion
In people with T2D, low fasting glucose and QTc-prolonging prokinetic, antibiotic, or antipsychotic medication use and a history of heart failure are associated with SCA risk. Subgroup analyses indicate antibiotic and antipsychotic medication use increases SCA risk specifically in those without CVD.
Study context
- Population
- People with T2D with and without cardiovascular disease (CVD), Dutch Noord-Holland region (2010–2020), routine primary care data
- Participants
- 689 vs 3,230
- Comparison
- Sudden cardiac arrest (SCA) cases vs matched non-SCA controls
- SCAn = 689
- Non-SCAn = 3,230reference
- Outcome
- Associations of clinical characteristics and medication use with SCA
Methodological detailslongitudinal, matched (age, sex, T2D, GP practice), up to five controls per case, multivariable time-dependent Cox regression
- Longitudinal
- Matched (age, sex, T2D, GP practice), up to five controls per case
- Multivariable time-dependent Cox regression
Main finding
As reported in the abstract
Associations with SCA in the total sample (HR, 95% CI)
- Low fasting glucose (<4.5 mmol/mol)
- 1.91 [1.00-3.64]
- Antihypertensive medication
- 1.80 [1.39-2.33]
- Glucose lowering: oral only
- 1.32 [1.06-1.63]
- Glucose lowering: insulin only
- 2.31 [1.71-3.12]
- Glucose lowering: oral and insulin
- 1.64 [1.21-2.22]
- HF
- 1.91 [1.55-2.35]
- QTc-prolonging prokinetic medication
- 1.78 [1.27-2.50]
- QTc-prolonging antibiotic medication
- 1.35 [1.05-1.73]
- QTc-prolonging antipsychotic medication
- 2.10 [1.42-3.09]
Observational data: associations, not effects.
Further findings
Subgroup effect modification: associations with SCA only in those without CVD (HR, 95% CI)
- QTc-prolonging antibiotic medication, no CVD
- 1.82 [1.26-2.63]
- QTc-prolonging antipsychotic medication, no CVD
- 3.10 [2.09-4.59]
Original publication
Associations of Clinical Characteristics With Sudden Cardiac Arrest in People With Type 2 Diabetes With and Without Cardiovascular Disease: A Longitudinal Case-Control Study Using Routine Primary Care Data. Diabetes Care. Published 18 November 2024. doi:10.
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