Abstract 4138: Risk of Coronary Death in Diabetes Requiring Anti-Diabetic Agents in Comparison to Individuals with a Prior MI for Both Genders at All Ages: A population Based Study of 3,3 Million
AIM: To identify subjects with diabetes at high risk of death from coronary heart diseases (CHD), we studied an unselected population of 3,3 million Danes.
METHODS: Residents in Denmark, ≥30 years, were followed for 5 years (1997–2001) by linkage of nationwide registers. Diabetic subjects, receiving anti-diabetic agents, with and without prior myocardial infarction (MI) (DM-PreMI and DM-noPreMI) were compared to individuals without diabetes, with and without prior MI (noDM-PreMI and noDM-noPreMI). CHD death was expressed as mortality rates per 1000 person-years. Rate ratios (RR) between groups were analysed using Poisson regression.
RESULTS: 3,274,479 subjects were included, 71,801 (2.2 %) had diabetes, 73,156 (2.3%) and 6,419 (8.9%) had prior MI in individuals without and with diabetics, respectively. Relative differences between groups were [RR=7,93(95%CI 7,45– 8,45)], [4,31(4,20– 4,42)] and [2,70 2,58–2,81)] for DM-PreMI, noDM-PreMI, DM-noPreMI respectively compared to noDM-noPreMI for men and the values for women were [RR=9,17 (95% 8,48–9,91 )], [4,44 (4,28– 4,59)] and [2,77 (2,65–2,89)] respectively (Fig⇓.).
CONCLUSION: Regardless of age and gender the risk of CHD death in subjects with diabetes receiving anti-diabetic agents is almost 75% the risk of subjects with a prior MI, whereas the risk for diabetic subjects with a prior MI was 2 times higher. Therefore, extensive screening and treatment for coronary risk factors should be implemented in all diabetic patients receiving medical anti-diabetic treatment.