title: The influence of cardiovascular autonomic neuropathy on mortality in type 1 diabetic patients; 10-year follow-up.
abstract: OBJECTIVE
  The aim of our retrospective study was to answer the question if the presence of cardiovascular autonomic neuropathy (CAN) affects mortality in type 1 diabetic patients during a 10-year follow-up.
  
  
  METHODS
  Patients with type 1 diabetes mellitus examined for CAN in 2003 were enrolled in this retrospective study. A total of 278 patients were included and divided into two groups according to the presence or absence of CAN (111 CAN+, 167 CAN-). The group characteristics and outcomes were compared at baseline and after ten years (in 2013).
  
  
  RESULTS
  In the follow-up period, a total of 18 patients died; CAN+ (14/111; 12.6%) and CAN- (4/167; 2.4%) (P < 0.001). At baseline, the CAN+ patients were older (47 vs. 33 years; P < 0.001), had longer duration of diabetes (20 vs. 12 years; P < 0.05), had worse glycemic control assessed by HbA1c (73 vs. 68 mmol/mol; P < 0.05), higher systolic (130 vs. 120 mmHg; P < 0.001) and diastolic (80 vs. 70 mmHg; P < 0.01) blood pressure and had more diabetic complications. In our analysis we found the strongest predictor of mortality to be the presence of CAN (P < 0.01) and the blood pressure value at baseline (P < 0.05). Other baseline characteristics, including the duration of diabetes, age and the presence of micro- and macrovascular complications were not significant. The statistical analysis was performed using logistic regression step-wise analysis.
  
  
  CONCLUSIONS
  During the 10-year follow-up, CAN+ patients had a 5-fold higher mortality rate than CAN- patients. The strongest predictor of mortality was the presence of CAN.
authors.affiliation: Department of Internal Medicine I, University Hospital in Pilsen and Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic.
authors.forename: Silvie
authors.initials: S
authors.lastname: Lacigova
authors.affiliation: Department of Internal Medicine I, University Hospital in Pilsen and Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic.
authors.forename: Jitka
authors.initials: J
authors.lastname: Brozova
authors.affiliation: Department of Internal Medicine I, University Hospital in Pilsen and Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic.
authors.forename: Daniela
authors.initials: D
authors.lastname: Cechurova
authors.affiliation: Department of Internal Medicine I, University Hospital in Pilsen and Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic.
authors.forename: Jitka
authors.initials: J
authors.lastname: Tomesova
authors.affiliation: Department of Internal Medicine I, University Hospital in Pilsen and Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Krcma
authors.affiliation: Department of Internal Medicine I, University Hospital in Pilsen and Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Rusavy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000401:mortality*; D001794:Blood Pressure / Q000502:physiology; D002423:Cause of Death; D018153:Czech Republic / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality*; D003925:Diabetic Angiopathies / Q000401:mortality*; D003928:Diabetic Nephropathies / Q000401:mortality*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin
keywords: cardiovascular autonomic neuropathy; chronic complications; morbidity; mortality; type 1 diabetic patients