Dose-dependent effect of smoking on risk of coronary heart disease, heart failure and stroke in individuals with type 1 diabetes

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Finndiane Study Grp 2018 , ' Dose-dependent effect of smoking on risk of coronary heart disease, heart failure and stroke in individuals with type 1 diabetes ' , Diabetologia , vol. 61 , no. 12 , pp. 2580-2589 . https://doi.org/10.1007/s00125-018-4725-9

Title: Dose-dependent effect of smoking on risk of coronary heart disease, heart failure and stroke in individuals with type 1 diabetes
Author: Finndiane Study Grp
Date: 2018-12
Language: eng
Number of pages: 10
Belongs to series: Diabetologia
ISSN: 0012-186X
URI: http://hdl.handle.net/10138/265092
Abstract: Aims/hypothesisThe aim of this study was to assess the potential dose-dependent effects of smoking on the risk of CHD, heart failure and stroke in individuals with type 1 diabetes.MethodsThe study included 4506 individuals with type 1 diabetes who were participating in the Finnish Diabetic Nephropathy (FinnDiane) study. Intensity of smoking was estimated by packs per day and cumulative smoking by pack-years. Cox regression analyses were used to estimate the risk of incident CHD, heart failure or stroke during follow-up.ResultsOne pack per day significantly increased the risk of incident CHD in current smokers compared with never smokers (HR 1.45 [95% CI 1.15, 1.84]), after adjustment for age, sex, HbA(1c), hypertension, duration of diabetes and BMI. The risk of CHD in former smokers was similar to the risk in never smokers. The risk of incident heart failure was 1.43 (95% CI 1.03, 1.97) in current smokers per one pack per day and 1.37 (95% CI 1.05, 1.77) in former smokers, while the risk of incident stroke was 1.70 (95% CI 1.26, 2.29) and 1.49 (95% CI 1.14, 1.93), respectively. After further adjustments for lipids, however, the difference in the risk of heart failure in current and former smokers was no longer significant. Cumulative smoking data were similar to smoking intensity data.Conclusions/interpretationThere is a dose-dependent association between smoking and cardiovascular disease in individuals with type 1 diabetes. In men in particular, the risk of incident stroke remains high even after smoking cessation and is increased in current and former smokers independently of other risk factors.
Subject: Cardiovascular disease
Coronary heart disease
Heart failure
Smoking
Stroke
Type 1 diabetes
CARDIOVASCULAR-DISEASE
CIGARETTE-SMOKING
PITTSBURGH EPIDEMIOLOGY
MYOCARDIAL-INFARCTION
HEMORRHAGIC STROKE
GLYCEMIC CONTROL
MORTALITY RISK
PACK-YEARS
MELLITUS
COMPLICATIONS
3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
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