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TYPE 2 DIABETES IS NOT A CORONARY ARTERY DISEASE RISK EQUIVALENT: RESULTS FROM AN 8-YEAR PROSPECTIVE COHORT STUDY ON ANGIOGRAPHICALLY CHARACTERIZED PATIENTS
E958 JACC April 5, 2011 Volume 57, Issue 14
MYOCARDIAL ISCHEMIA AND INFARCTION TYPE 2 DIABETES IS NOT A CORONARY ARTERY DISEASE RISK EQUIVALENT: RESULTS FROM AN 8-YEAR PROSPECTIVE COHORT STUDY ON ANGIOGRAPHICALLY CHARACTERIZED PATIENTS ACC Poster Contributions Ernest N. Morial Convention Center, Hall F Sunday, April 03, 2011, 10:00 a.m.-11:15 a.m.
Session Title: Stable Ischemic Syndrome: Predictors and Models Abstract Category: 5. Stable Ischemic Syndrome Session-Poster Board Number: 1006-362 Authors: Christoph H. Saely, Tobias Gansch, Alexander Vonbank, Philipp Rein, Stefan Beer, Susanne Greber, Heinz Drexel, Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria, Private University of the Principality of Liechtenstein, Triesen, Liechtenstein Background: Current guidelines consider diabetes as a coronary artery disease (CAD) risk equivalent, but cardiovascular risk in patients with diabetes may vary substantially depending on the presence of subclinical CAD at baseline. Methods: Vascular events were recorded over 8 years in 750 consecutive patients undergoing coronary angiography for the evaluation of established or suspected stable CAD. Results: From our patients, 244 had neither type 2 diabetes (T2DM) nor significant CAD (i.e. coronary stenoses ≥50%) at the baseline angiography, 50 had T2DM but not significant CAD, 342 did not have T2DM but had significant CAD, and 114 had both T2DM and significant CAD. Non-diabetic subjects without significant CAD had an event rate of 20.5%. The event rate was similar in T2DM patients without significant CAD (22.0%; p = 0.811), but higher in non-diabetic patients with significant CAD (39.5%, p <0.001). Patients with T2DM plus significant CAD had the highest event rate (53.5%; p <0.001). Importantly, T2DM patients without significant CAD had a significantly lower event rate than non-diabetic patients with significant CAD (p = 0.017). Conclusion: T2DM per se is not a CAD risk equivalent. Moderate risk diabetic patients without significant CAD and very high-risk diabetic patients with significant CAD add up to a grand total of high risk diabetic patients: this is why diabetes appears as a CAD risk equivalent in many epidemiological studies.
MYOCARDIAL ISCHEMIA AND INFARCTION TYPE 2 DIABETES IS NOT A CORONARY ARTERY DISEASE RISK EQUIVALENT: RESULTS FROM AN 8-YEAR PROSPECTIVE COHORT STUDY ON ANGIOGRAPHICALLY CHARACTERIZED PATIENTS ACC Poster Contributions Ernest N. Morial Convention Center, Hall F Sunday, April 03, 2011, 10:00 a.m.-11:15 a.m.
Session Title: Stable Ischemic Syndrome: Predictors and Models Abstract Category: 5. Stable Ischemic Syndrome Session-Poster Board Number: 1006-362 Authors: Christoph H. Saely, Tobias Gansch, Alexander Vonbank, Philipp Rein, Stefan Beer, Susanne Greber, Heinz Drexel, Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria, Private University of the Principality of Liechtenstein, Triesen, Liechtenstein Background: Current guidelines consider diabetes as a coronary artery disease (CAD) risk equivalent, but cardiovascular risk in patients with diabetes may vary substantially depending on the presence of subclinical CAD at baseline. Methods: Vascular events were recorded over 8 years in 750 consecutive patients undergoing coronary angiography for the evaluation of established or suspected stable CAD. Results: From our patients, 244 had neither type 2 diabetes (T2DM) nor significant CAD (i.e. coronary stenoses ≥50%) at the baseline angiography, 50 had T2DM but not significant CAD, 342 did not have T2DM but had significant CAD, and 114 had both T2DM and significant CAD. Non-diabetic subjects without significant CAD had an event rate of 20.5%. The event rate was similar in T2DM patients without significant CAD (22.0%; p = 0.811), but higher in non-diabetic patients with significant CAD (39.5%, p <0.001). Patients with T2DM plus significant CAD had the highest event rate (53.5%; p <0.001). Importantly, T2DM patients without significant CAD had a significantly lower event rate than non-diabetic patients with significant CAD (p = 0.017). Conclusion: T2DM per se is not a CAD risk equivalent. Moderate risk diabetic patients without significant CAD and very high-risk diabetic patients with significant CAD add up to a grand total of high risk diabetic patients: this is why diabetes appears as a CAD risk equivalent in many epidemiological studies.