People with ethnic background from South Asian countries have a higher risk of developing diabetes and diseases of the heart and blood vessel, compared with people of other ethnicities. Diabetes is three times more common in South Asians than in Whites and is diagnosed over a decade earlier. Recently, however, there have been significant improvements in the diagnosis and treatment of diabetes, which have resulted in a lower risk of complications and death for Whites. It is not known, however, if South Asians experienced the same improvements. Moreover, following a diseases of the heart and blood vessel, the probability of death is greater for patients with diabetes compared to those without. However, it is not known whether the increased risk of death in patients with diabetes is different according to the ethnicity.
Using data from the Clinical Practice Research Datalink (CPRD), this study aims to investigate the age at onset of several diseases of the heart and blood vessels and survival differences after the onset of these diseases comparing subjects with and without diabetes for Whites, South Asians, Blacks, and other ethnicities. This study will contribute to the evidence on health differences related to ethnicity and diabetes status and will help personalise guideline treatments for cardiovascular diseases.
Using data collected in the CPRD Gold Database with linkage to HES admitted patient care and ONS death registry, the primary aim of the study is to assess the age at onset of several cardiovascular disease conditions (including myocardial infarction, coronary death, heart failure, transient ischaemic attack, ischaemic stroke, peripheral arterial disease) and survival differences (i.e., prognosis) for these multiple cardiovascular disease conditions following the diagnosis, compared by diabetes status and ethnicity. In particular, this study will include a retrospective cohort of patients aged 18 years or over, with or without a diagnosis of type 2 diabetes mellitus (T2DM) at study entry. A survival analysis will be applied to assess whether diabetes status and ethnicity influence the age at onset of the cardiovascular diseases and the survival following the cardiovascular disease event. Self-reported ethnicity is obtained from HES and CPRD data, and categorized as White, South Asian (including Indian, Pakistani, and Bangladeshi, and mixed Asian), Black (including Caribbean, African, and mixed Black), or other.
Incidence of multiple cardiovascular disease conditions: myocardial infarction, coronary death, stable angina, unstable angina, heart failure, transient ischaemic attack, ischaemic stroke, subarachnoid haemorrhage, intracerebral haemorrhage, peripheral arterial disease, abdominal aortic aneurysm, PTCA, or coronary artery bypass grafting
- Years of life lost after the onset of any of the above condition, by diabetes and ethnicity status
Francesco Zaccardi - Chief Investigator - University of Leicester
Francesco Zaccardi - Corresponding Applicant - University of Leicester
Briana Coles - Collaborator - University of Leicester
Kamlesh Khunti - Collaborator - University of Leicester
Melanie Davies - Collaborator - University of Leicester
Suping Ling - Collaborator - University of Leicester
Yogini V Chudasama - Collaborator - Leicester Diabetes Centre
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation