Pattern and outcome of the first manifestation of cardiovascular disease among patients with type 2 diabetes mellitus in Cameroon: a cross-sectional study

BMC Cardiovasc Disord. 2024 Oct 26;24(1):593. doi: 10.1186/s12872-024-04272-5.

Abstract

Background: Cardiovascular diseases (CVDs) are the most common cause of morbidity and mortality among patients with type 2 diabetes mellitus (T2DM). There is a paucity of data on the pattern of first manifestation of CVD and the outcome among patients with T2DM in Cameroon.

Objectives: We aimed to examine the pattern of the first manifestation of CVD and the outcome among patients with T2DM.

Methods: Between January 2017 and December 2023, files of patients with T2DM hospitalized for the first observed CVD were reviewed. We identified cases of three incident overt clinically manifest CVD complications (acute myocardial infarction [AMI], stroke, and heart failure) in hospitalized T2DM patients. Patients with a previous history of CVD were excluded.

Results: Out of the 1091 patients hospitalized with T2DM, we identified 261(23.9%) patients with clinically overt CVD, of whom 129 (49.4%) were females. The mean age was 63.9 ± 12.1 years and ranged from 15 to 91 years. Women were significantly older compared to men (65.4 ± 11.4 years vs. 62.5 ± 12.6 years; p = 0.042). Hypertension was reported in 201 (77%; 95% CI: 71.4-82) patients. Any form of chronic kidney disease was seen in 15 (5.8%; 95% CI: 3.3-9.3) patients. HIV infection was seen in 5 (1.9%; 95% CI: 0.6-4.4) patients. Stroke was the most common incident clinically overt CVD in 144 (55.2%; 95% CI: 48.9-61.3) patients, followed by heart failure in 105 (40.2%; 95% CI: 34.2-46.5) patients, and Acute MI in 12 (4.6%; 95% CI: 2.4-7.9) patients. The mean length of hospital stay was 9.7 ± 6.6 days. Patients with stroke had a significantly longer hospital stay > 7 days (63% vs. 48.7%, p = 0.021). The in-hospital case fatality was seen in 35 (13.4%; 95% CI: 9.5-18.2) patients.

Conclusion: Nearly 1 out of 4 hospitalized patients with T2DM was hospitalized for a first CVD. Stroke and heart failure are the most common initial manifestations of CVD. More than three-quarters of the patients had concomitant hypertension and the in-hospital case fatality was high.

Clinical trial number: Not applicable.

Keywords: Africa; Cardiovascular disease; Diabetes mellitus; Mortality.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cameroon / epidemiology
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / mortality
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / diagnosis
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes Mellitus, Type 2* / mortality
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / epidemiology
  • Heart Failure / mortality
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / mortality
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / epidemiology
  • Stroke / mortality
  • Time Factors
  • Young Adult