Some Diabetes Patients Have Same Risk of MI as Patients Without Diabetes

A recent study showed that patients with diabetes without coronary artery disease (CAD) who use prophylactics, like statins and aspirin, face the same risk of myocardial infarction (MI) and other cardiovascular (CV) events as patients without diabetes without CAD.

Patients with diabetes face a higher risk of MI and other CV events compared with patients without diabetes. As a result, patients with diabetes and risk factors for ischemic heart disease are typically prescribed prophylactic treatment.
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In their study, the researchers evaluated a cohort of 93,866 patients registered in the Western Denmark Heart Registry who had undergone coronary angiography (CAG) between January 1, 2003, and December 31, 2012. Patients were classified according to the presence or absence of diabetes and obstructive CAD. Median follow-up lasted 4.1 years.

The researchers defined the primary outcomes as death, cardiac death, and MI. They also determined the unadjusted and adjusted rate ratios, using patients without diabetes and without CAD as the reference group.

Results indicated that 12,544 patients (13.4%) had had diabetes at the time of CAG. Ultimately, the researchers found that both patients with and without diabetes without obstructive CAD had the same adjusted risk of death, cardiac death, and MI. Additionally, patients with diabetes without CAD more frequently received statins and aspirin, compared with patients without diabetes and CAD.

“In a real-world population, patients with diabetes with high rates of statin and aspirin treatment had the same risk of cardiovascular events as patients without diabetes in the absence of angiographically significant CAD,” the researchers concluded.

—Christina Vogt

Reference:

Olesen KKW, Madsen M, Egholm G, et al. Patients with diabetes without significant angiographic coronary artery disease have the same risk of myocardial infarction as patients without diabetes in a real-world population receiving appropriate prophylactic treatment. Diabetes Care. 2017;40(8):1103-1110. https://doi.org/10.2337/dc16-2388.