Grant: Project Grant

Diabetes mellitus (DM) is a major public health crisis in Canada: by 2030, over 1 in 5 individuals are projected to develop DM resulting in total costs to the Canadian healthcare system of $336 billion over the next 10 years. The presence of DM is one of the strongest risk factors for the development of cardiovascular (CV) diseases including heart failure (HF), myocardial infarction (MI), stroke, and CV death. Despite nearly half of all people with type 2 DM in Canada are biologically female, there has been surprisingly little evaluation of the sex specific distribution of clinical predictors for cardiovascular outcomes. As highlighted by consensus guidelines, the distribution, predictors, and mechanisms associated with sex differences relating to cardiovascular outcomes among people with DM has historically neglected. This knowledge gap is even more apparent in people with DM who have had a recent heart attack, where the risk of recurrent cardiovascular events is significantly increased. Clinical variables combined with blood-based proteins (biomarkers) allow us to create models that can more precisely predict clinical outcomes. Furthermore, using multiple biomarkers, we can create 'biomarker profiles' that allow us to determine how and why certain people develop adverse outcomes. We propose the 'Identification and prediction of sex-specific cardiovascular causes of death and outcomes in people with Diabetes Mellitus post Myocardial Infarction' (SCD-DM-MI) study to address these knowledge gaps. We will use several large clinical trial databases with large number of biomarkers that have been measured to identify the clinical factors and biomarker profiles associated with specific cardiovascular outcomes. This will lay the foundation to allow us to target health services interventions and therapies to those who need it the most and identify new possible drug targets.