Diabetes and Heart Disease Combo Significantly Increases Mortality Risk

Individuals with type 2 diabetes who are admitted to the hospital for acute coronary syndrome have a significantly higher mortality risk than those who do not have a cardiovascular (CV) event, according to results presented at the American Diabetes Association’s annual meeting in New Orleans.

Researchers who were previously involved in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) study sought to evaluate the risk of CV death in study participants who experienced major nonfatal CV events.
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The study randomly assigned 5380 patients with type 2 diabetes to either alogliptin or placebo 15 to 90 days following an acute coronary syndrome (ACS). Patients were monitored until censoring or death, regardless of a prior postrandomized nonfatal CV event.

Overall, 736 individuals experienced a first nonfatal CV event. The adjusted hazard ratio for death was 3.12 after myocardial infarction, 4.96 after hospitalized heart failure, 3.08 after stroke, and 1.66 after unstable angina, compared with those who did not experience a nonfatal event. Mortality rates following a nonfatal event were comparable for alogliptin and placebo.

“In patients with type 2 diabetes and a recent ACS, the risk of CV death was higher after a postrandomization, nonfatal CV event, particularly heart failure, compared with those who did not experience a CV event. The risk of CV death was similar between alogliptin and placebo.”

—Michael Potts

Reference:

White WB, Kupfer S, Zannad F, et al; EXAMINE Investigators. Cardiovascular mortality in patients with type 2 diabetes and recent acute coronary syndromes from the EXAMINE trial [published online June 11, 2016]. Diabetes Care. http://dx.doi.org/10.2337/dc16-0303.