Cardiovascular Events in Diabetic and Nondiabetic Adults With or Without History of Myocardial Infarction

Lee, Chong Do; Folsom, Aaron R.; Pankow, James S.; Brancati, Frederick L.

doi:10.1161/01.cir.0000116389.61864.de

Cited by 276Diabetes, Cardiovascular Risks, and LipoproteinsAcute Myocardial Infarction ResearchHealthcare Systems and Public Health

Cardiovascular Events in Diabetic and Nondiabetic Adults With or Without History of Myocardial Infarction

Lee, Chong Do, Folsom, Aaron R., Pankow, James S., Brancati, Frederick L.·2004·Circulation

DOI 10.1161/01.cir.0000116389.61864.de

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Abstract

Background— Whether diabetic patients without a history of myocardial infarction (MI) have the same risk of coronary heart disease (CHD) events as nondiabetic patients with a history of MI remains controversial. We compared risks of CHD and stroke events and mortality from cardiovascular disease (CVD) in diabetic and nondiabetic men and women with and without a history of MI. Methods and Results— We followed a total of 13 790 African American and white men and women ages 45 to 64 years who participated in the Atherosclerosis Risk in Communities study, beginning in 1987 to 1989. There were 634 fatal CHD or nonfatal MI events, 312 fatal or nonfatal strokes, and 358 deaths from CVD during an average of 9 years of follow-up (125 998 person-years). After adjustment for age, sex, race, Atherosclerosis Risk in Communities field center, and multiple baseline risk factors, patients who had a history of MI without diabetes at baseline had 1.9 times the risk of fatal CHD or nonfatal MI (95% CI, 1.35 to 2.56; P <0.001) compared with diabetic patients without a prior history of MI. The nondiabetic patients with MI also had 1.8 times the risk of CVD mortality compared with diabetic patients without MI (95% CI, 1.22 to 2.72; P =0.003). However, stroke risk was similar between diabetic patients without MI and nondiabetic patients with MI (RR, 1.05; 95% CI, 0.61 to 1.79; P =0.87). We also observed that nondiabetic patients with MI had a carotid artery wall thickness similar to diabetic patients without MI ( P =0.77). Conclusions— Diabetic patients without MI had lower risk of CHD events and mortality from CVD compared with nondiabetic patients with MI, but stroke risk was similar between these 2 groups.

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Several statin trials with large type 2 diabetes subpopulations, including GREACE, TNT, and PROVE IT, have shown significant reductions in mortality and cardiovascular events.
“However, several statin trials with large T2D subpopulations, including the GREACE (GREek Atorvastatin and Coronary-Heart-Disease Evaluation) study, TNT (Treating to New Targets) study, and PROVE IT (Pravastatin or Atorvastatin Evaluation and Infection Therapy) trial, have shown significant reductions in mortality and CVD events.”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [328]
The Discussion (page unavailable) mentions statins only as preventive agents the authors could not account for in their ARIC analysis. Searches for GREACE, TNT, PROVE IT, and statin-trial reductions found no passage reporting the claimed mortality or cardiovascular-event benefits. (LLM, conf=0.78)
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Original Article: Epidemiology Is diabetes a coronary risk equivalent? Systematic review and meta-analysis
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Mortality from Coronary Heart Disease in Subjects with Type 2 Diabetes and in Nondiabetic Subjects with and without Prior Myocardial Infarction
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Authors: Lee, C. D., Folsom, A. R., Pankow, J. S., & Brancati, F. L.
Affiliations: University of Minnesota (US)
ORCID: Folsom, Aaron R.
Pankow, James S.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2004-02-24
Volume: 109
Issue: 7
Pages: 855-860
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.0000116389.61864.de
OpenAlex: W2089154533
Cited by: 276
References: 40
Citations by year: 2026: 3 · 2025: 3 · 2024: 6 · 2023: 5 · 2022: 6 · 2021: 11 · 2020: 7 · 2019: 9 · 2018: 6 · 2017: 8 · 2016: 9 · 2015: 10 · 2014: 9 · 2013: 10 · 2012: 16
FWCI: 18.67
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (n01hc55021-47-0-1, n01hc55020-39-0-0, n01hc55016-37-0-0, n01hc055022-024, n01hc55019-35-0-1, n01hc55018-38-0-1, n01hc55015-48-0-1)
National Heart, Lung, and Blood Institute (N01-HC55022, N01-HC-55018, N01 HC 55020, N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022, N01 HC 55019, N01-HC55016, N01‐HC‐55015, N01-HC55021, T32 HL07779, HL07779, T32HL007779)
National Institute of Diabetes and Digestive and Kidney Diseases (1K24 DK 6222-01, N01-HC-55016, N01-HC-55018, N01-HC-55021, N01-HC-55020, N01-HC-55015, N01-HC-55019, N01-HC-55022)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
Keywords: diabetes mellitus, myocardial infarction, coronary artery disease, stroke, cardiovascular mortality, cardiovascular risk, carotid intima-media thickness, African American adults, Atherosclerosis Risk in Communities Study
MeSH terms: Black or African American, Cardiovascular Diseases, Carotid Arteries, Diabetes Mellitus, Female, Follow-Up Studies, Humans, Hypercholesterolemia, Hypertension, Male, Middle Aged, Myocardial Infarction, Obesity, Risk, Smoking, Ultrasonography, United States, Cohort Studies, Comorbidity, Life Tables, Survival Analysis, Tunica Intima, Tunica Media, Stroke, White People

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Cardiovascular Events in Diabetic and Nondiabetic Adults With or Without History of Myocardial Infarction

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