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Angina Does Not Impact Adverse Cardiovascular Outcomes in Persons With Diabetes and Stable Coronary Artery Disease
According to the American Heart Association, at least 65% of adults with type 2 diabetes will die from a stroke, myocardial infarction, or another cardiovascular complication, making assessment of mortality risk essential for this population. Because angina is common in persons with type 2 diabetes and coronary artery disease (CAD), Gilles Dagenais, MD, Quebec Heart and Lung University Institute, Quebec City, and colleagues performed a post-hoc analysis of the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial to assess the prognostic significance of the presence or absence of angina on mortality and cardiovascular outcomes in persons with these conditions.
Dagenais and colleagues’ study included a total of 2364 patients with type 2 diabetes and stable CAD, of whom 1434 had angina, 506 had angina equivalents (eg, dyspnea, diaphoresis, extreme fatigue, or pain at a site other than the chest), and 424 had neither at baseline. The authors compared the occurrence of death, myocardial infraction, stroke symptoms, and composite of death at 5-year follow-up between groups. There were a total of 316 deaths, with a cumulative death rate of 12% for those with angina, 14% for those with an angina equivalent, and 10% for those with neither (P=.3). The cumulative cardiovascular composite rates were 24% for those with angina, 24% in those with an angina equivalent, and 21% for those with neither (P=.5).
Because the risk of death and cardiovascular events was found to be similar between patients with and without angina or its equivalents, the authors concluded that patients with type 2 diabetes and stable CAD could be treated similarly with regard to risk stratification and preventive therapies, regardless of whether they have angina. For more information about this study, visit http://1.usa.gov/WDN1Wf.