Diabeten hebben lager lange-termijn risico dan niet-diabeten na AMI

Patients with Type 2 diabetes have a significantly lower 10-year incidence of coronary heart disease (CHD) and cardiovascular mortality than nondiabetic patients with a first acute myocardial infarction (AMI).

There has been great debate about whether having Type 2 diabetes is a cardiovascular disease equivalent, with some studies arguing for and some against.

Writing in the journal Diabetes Care, Jaume Marrugat (IMIM, Barcelona, Spain) and colleagues report the long-term results of a population-based cohort study in Spain that included 4410 patients aged 30-74 years. Of these, 2260 had Type 2 diabetes but no CHD at baseline, and 2150 were nondiabetic patients with a first AMI.

Men and women with diabetes had a significant 46% and 72% lower relative risk for developing CHD, respectively, over the 10-year study period than those with AMI. Cardiovascular mortality was also a respective 74% and 84% lower in men and women with diabetes compared with those with AMI.

When the participants were stratified according to individual cardiovascular event type, eg, MI, stroke, unstable angina, all-cause death, coronary death, and stroke death, diabetic patients had significantly lower event rates for all outcomes than AMI patients, with hazard ratios ranging from 0.15 to 0.66.

"The results of our study indicate that Type 2 diabetic patients without previous CHD not only have lower 10-year cardiovascular mortality but also have lower CHD incidence than first AMI patients without diabetes," summarize Marrugat et al.

The authors concede that geographical variation may partly explain differences between the results of this study and others in the literature, but conclude that their results "do not support equivalence in coronary disease risk for diabetic and MI patients."