Hua‑Fen Chen, - and Ya‑Hui Chang, - and Hsien‑Jung Lo, - and Muhammad Atoillah Isfandiari, - and Santi Martini, - and Wen‑Hsuan Hou, - and Chung‑Yi Li, - (2020) Incidence of idiopathic cardiomyopathy in patients with type 2 diabetes in Taiwan: age, sex, and urbanization status-stratifed analysis. Cardiovascular Diabetology, 19. pp. 1-15. ISSN 14752840

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Abstract

Background: The epidemiology of diabetes and idiopathic cardiomyopathy have limited data. We investigated the overall and the age , sex , and urbanization specifc incidence and relative hazard of idiopathic cardiomyopathy in association with type 2 diabetes and various anti diabetic medications used in Taiwan. Methods: A total of 474,268 patients with type 2 diabetes were identifed from ambulatory care and inpatient claims in 2007–2009 from Taiwan’s National Health Insurance (NHI) database. We randomly selected 474,266 age , sex , and diagnosis date matched controls from the registry of NHI benefciaries. All study subjects were linked to ambulatory care and inpatient claims (up to the end of 2016) to identify the possible diagnosis of idiopathic cardiomyopathy. The person year approach with Poisson assumption was used to estimate the incidence, and Cox proportional hazard regression model with Fine and Gray’s method was used to estimate the relative hazards of idiopathic cardiomyopathy in relation to type 2 diabetes. Results: The overall incidence of idiopathic cardiomyopathy for men and women patients, respectively, was 3.83 and 2.94 per 10,000 person years, which were higher than the corresponding men and women controls (2.00 and 1.34 per 10,000 person years). Compared with the control group, patients with type 2 diabetes were signifcantly associated with an increased hazard of idiopathic cardiomyopathy (adjusted hazard ratio [aHR]: 1.60, 95% confdence interval [CI]: 1.45–1.77] in all age and sex stratifcations except in those men aged > 64 years. Patients with type 2 diabetes aged < 45 years confronted the greatest increase in the hazard of idiopathic cardiomyopathy, with an aHR of 3.35 (95% CI 2.21–5.06) and 3.48 (95% CI 1.60–7.56) for men and women, respectively. The usage of some anti diabetic medications revealed lower risks of idiopathic cardiomyopathy. Conclusions: In Taiwan, diabetes increased the risk of idiopathic cardiomyopathy in both sexes and in all age groups, except in men aged > 64 years. Younger patients were vulnerable to have higher HRs of idiopathic cardiomyopathy. Some anti diabetic medications may reduce the risks of cardiomyopathy.

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