The text discusses whether diabetes is treated as a coronary artery disease risk equivalent in clinical practice, as recommended by guidelines.
O bservational studies (1–3) havesuggested that the risk of mortalityis equivalent for patients with myo-cardial infarction (MI) without previous diabetes and for diabetic patients without previous MI. Because vascular risk-reduction targets are based on a patient’s future risk, clinical practice guidelines (4–9) recommend that the same or lower blood pressure and lipid targets be ap-plied to diabetic patients as would be ap-plied for secondary prevention following MI. Patients newly diagnosed with diabe-tes and those with first MIs enter a high-risk category for subsequent coronary events. Therefore, if diabetes were treated as a coronary artery disease risk equiva-
Shah et al. (Fri,) studied this question.