Diabetes Significantly Increases Risk Of Death

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Nearly 65 percent of individuals with diabetes die from cardiovascular disease in the United States, yet the independent effect of diabetes on mortality following acute coronary syndromes is not clear. Researchers from the TIMI Study Group in Brigham and Women's Hospital's (BWH) cardiovascular division studied the influence of diabetes on death rates among individuals who experienced acute coronary syndromes (ACS), such as an acute heart attack, 30 days and one-year following such events.

The researchers found that after 30 days the risk of death for diabetics experiencing acute coronary syndromes (which covers the full spectrum from unstable angina through mild or severe heart attack) was two times greater compared to non-diabetic individuals experiencing the same type of coronary event. The findings appear in the August 15, 2007 issue of the Journal of the American Medical Association.

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To analyze the effect of diabetes on individuals who experienced ACS the researchers pooled participants from 11 independent clinical trials, spanning nine years, from the BWH-based Thrombolysis in Myocardial Infarction (TIMI) Study Group. The analysis group was comprised of more than 62,000 individuals, more than 10,000 of whom were diabetic, from 55 countries and more than 900 clinical sites.

"Despite the numerous advances that have been made in coronary care treatment, they are not enough to off-set the very serious increased risk of death faced by diabetics experiencing acute coronary syndromes," said Elliott Antman, M.D., director of the Samuel L. Levine Cardiac Unit at BWH and senior author of the study. "Collaboration between medical organizations, health care groups and industry will be crucial to halt the epidemic of diabetes-related heart disease."

"We found that at one year diabetics who had a less-severe type of heart attack (non-STEMI) were at virtually the same risk of dying compared with a non-diabetic who had suffered a more severe type of heart attack (STEMI)." Antman continued.

Those in the study with diabetes who experienced ACS were older, more often women, had higher body mass index and were more likely to have a history of high blood pressure, high cholesterol levels, past heart attack, coronary bypass surgery and heart failure compared with the non-diabetics in the study. Additionally, of the 55 countries and 900 clinical sites pooled for this study, there was a higher prevalence of diabetes in the North American sites compared with the other regions around the world.

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