Infections Are Linked to CHD Risk in Patients With Diabetes

Bacterial infections could raise the risk of coronary heart disease (CHD) in patients with type 1 diabetes, according to the results of a recent study.

Diabetes has been shown to be associated with both an increased risk of infections as well as increased risk of CHD, but whether the two are connected causally is not well understood.

The researchers recruited 3781 patients with type 1 diabetes from the Finnish Diabetic Nephropathy Study. They defined CHD as fatal or non-fatal myocardial infarction, coronary artery bypass surgery, or percutaneous coronary intervention. Antibiotic purchases from outpatient care were used to identify infections.

Overall, 370 participants experienced a CHD event. These individuals had a higher mean number of antibiotic prescriptions per year than did those without CHD events. Using multivariable-adjusted Cox proportional hazards models, the researchers found that the number of antibiotic purchases per year was an independent risk factor for CHD (Hazard ratio [HR] 1.21, 95% CI: 1.14–1.29, P < 0.0001).

“We were able to study the association between antibiotic purchases, endotoxemia and incident CHD in one of the largest cohorts of individuals with type 1 diabetes. In this study, we found both high LPS activity and frequent antibiotic purchases to be strong, independent risk factors for incident CHD in individuals with type 1 diabetes, lending support to research demonstrating infections as risk factors for CHD. More studies are needed to further elucidate the pathophysiologic mechanisms behind this association,” the researchers concluded.

—Michael Potts

Reference:

Simonsen JR, Jarvinen A, Harjutsalo V, et al. The association between bacterial infections and the risk of coronary heart disease in type 1 diabetes. Published online August 4, 2020. JIM. doi: 10.1111/joim.13138