Coronary heart disease in diabetics: Prognostic implications and results of interventions

OBJECTIVES: The aim of the present study was to compare the extent of coronary disease and subsequent survival in diabetics and non-diabetics. DESIGN: From the database at Feiring Heart Clinic 13511 patients were identified with no previous revascularization and were examined with coronary angiography in the period from March 1999 to December 31, 2005. In the cohort 1,475 patients were diabetics. Their survival status of May 31, 2006 was ascertained through the Norwegian National Registry. RESULTS: Diabetics were more symptomatic and had a more severe coronary artery disease at the time of referral with more than 40% having three vessel disease. The unadjusted survival was lower in the diabetics. After adjustment through Cox regression, diabetes mellitus remained a risk factor for subsequent death (overall hazard ratio 1.33), with the excess mortality mainly residing in smoking diabetics. CONCLUSIONS: Diabetics were more severely diseased at the time of referral. In Cox regression diabetes mellitus remained a significant risk factor for death in smokers except in the cohort treated with CABG.