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Evid Based Med 2009;14:136-137 doi:10.1136/ebm.14.5.136
  • Therapeutics

Review: diabetes is not a coronary disease equivalent

Question

Do patients with diabetes and no history of myocardial infarction (MI) have similar risk of coronary artery disease (CAD) events as patients with previous MI and no diabetes?

Review scope

Included studies compared risk for CAD events in patients with diabetes and no MI and patients with previous MI and no diabetes. Outcomes were fatal or non-fatal MI.

Review methods

Medline and EMBASE/Excerpta Medica (to Apr 2007); Cochrane Central Register of Controlled Trials; and references were searched for cohort studies involving ≥100 patients with follow-up ≥4 years. 13 articles reporting on 14 cohorts (n = 47 361, age 25–84 y, 0–100% men) met the selection criteria. Mean duration of follow-up was 13 years (range 5 to 25 y). Patients were enrolled at either a cross-sectional point in time (12 cohorts) or at diagnosis of diabetes or first MI (2 cohorts).

Main results

Compared with patients with previous MI and no diabetes, those with diabetes and no MI had lower risk of a CAD event (table).

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Risk of fatal or non-fatal myocardial infarction (MI) in patients with diabetes and no history of MI compared with patients with previous …

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