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The British Journal of Diabetes & Vascular Disease
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Cardiovascular events in patients with type 2 diabetes

Erland Erdmann

Clinic for Internal Medicine, University of Köln, Joseph Stelzmann Str. 9, Köln D-50924, Germany, erland.erdmann{at}uni-koeln.de

Diabetes is a common risk factor for cardiovascular disease. Coronary heart disease and left ventricular dysfunction are more common in diabetic patients than in non-diabetic patients, and diabetic patients benefit less from revascularisation procedures. This increased risk can only partly be explained by the adverse effects of diabetes on established risk factors; hence, a substantial part of the excess risk must be attributable to direct effects of hyperglycaemia and diabetes. In type 2 diabetes, hyperinsulinaemia, insulin resistance and hyperglycaemia have a number of potential adverse effects, including effects on endothelial function and coagulation. Risk factor modification has been shown to reduce the occurrence of cardiovascular events in patients with diabetes; indeed, diabetic patients appear to benefit more in absolute terms than non-diabetic patients. There is thus a strong case for intensive treatment of risk factors, including insulin resistance and hyperglycaemia, in patients with type 2 diabetes.

Key Words: coronary heart disease • pioglitazone • risk factors • type 2 diabetes.

References

  • Pan W.-H, Cedres LB, Liu K. et al. Relationship of clinical diabetes and asymptomatic hyperglycemia to risk of coronary heart disease mortality in men and women. Am J Epidemiol 1986;123:504-16.[Abstract/Free Full Text]
  • Reunanen A. Diabetes as a risk factor for coronary heart disease. In: Oliver MF, Vedin A, Wilhelmsson C (eds.). Myocardial infarction in women. Edinburgh: Churchill Livingstone, 1986.
  • Stamler J., Vaccaro O., Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-year cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 1993;16:434-44.[Abstract]
  • Kuller LH, Velentgas P., Barzilay J. et al. Diabetes mellitus: subclinical cardiovascular disease and risk of incident cardiovascular disease and all-cause mortality. Arterioscler Thromb Vasc Biol 2000;20:823-9.[Abstract/Free Full Text]
  • Hayden JM, Reaven PD Cardiovascular disease in diabetes mellitus Type 2: a potential role for novel cardiovascular risk factors. Curr Opin Lipidol 2000;11:519-28.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Elkeles RS Blood glucose and coronary heart disease. Eur Heart J 2000; 21:1735-7.[Free Full Text]
  • Hauner H. Occurrence of diabetes mellitus in Germany [in German]. Dtsch Med Wochenschr 1998;123:777-82.[Medline] [Order article via Infotrieve]
  • Tenerz Å., Lonnberg I., Berne C., Nilsson G., Leppert J. Myocardial infarction and prevalence of diabetes mellitus. Is increased casual blood glucose at admission a reliable criterion for the diagnosis of diabetes? Eur Heart J 2001;22:1102-10.[Abstract/Free Full Text]
  • www.chd-taskforce.de. Accessed September 17, 2001.
  • Claudi T., Midthjell K., Holmen J., Fougner K., Krüger Ø, Wiseth W. Cardiovascular disease and risk factors in persons with Type 2 diabetes diagnosed in a large population screening. The Nord-Trøndelag Diabetes Study, Norway. J Intern Med 2000;248:492-500.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Chen W., Bao W., Begum S., Elkasabany A., Srinivasan SR, Berenson GS Age-related patterns of the clustering of cardiovascular risk variables of Syndrome X from childhood to young adulthood in a population made up of black and white subjects. The Bogalusa Heart Study. Diabetes 2000;49:1042-8.[Abstract]
  • Haffner SM, Lehto S., Ronnemaa T., Pyörälä K., Laakso M. Mortality from coronary heart disease in subjects with Type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998;339:229-34.[Abstract/Free Full Text]
  • Herlitz J., Malmberg K., Karlson BW, Rydén L., Hjalmarson Å. Mortality and morbidity during a five-year follow-up of diabetics with myocardial infarction. Acta Med Scand 1988;224:31-8.[Web of Science][Medline] [Order article via Infotrieve]
  • The BARI Investigators. Influence of diabetes on 5-year mortality and morbidity in a randomized trial comparing CABG and PTCA in patients with multivessel disease: the Bypass Angioplasty Revascularization Investigation (BARI). Circulation 1997;96:1761-9.[Abstract/Free Full Text]
  • Hasdai D., Granger CB, Srivatsa SS et al. Diabetes mellitus and outcome after primary coronary angioplasty for acute myocardial infarction: lessons from the GUSTO-IIb Angioplasty Substudy. Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes. J Am Coll Cardiol 2000;35:1513-5.[Free Full Text]
  • McGuire DK, Emanuelsson H., Granger CB et al. Influence of diabetes mellitus on clinical outcomes across the spectrum of acute coronary syndromes. Findings from the GUSTO-IIb Study. Eur Heart J 2000;21:1750-8.[Abstract/Free Full Text]
  • Waldecker B., Waas W., Haberbosch W. et al. Type 2 diabetes and acute myocardial infarction. Angiographic findings and results of an invasive therapeutic approach in Type 2 diabetic versus nondiabetic patients. Diabetes Care 1999;22:1832-8.[Abstract/Free Full Text]
  • Stein B., Weintraub WS, Gebhart SP et al. Influence of diabetes mellitus on early and late outcome after percutaneous transluminal coronary angioplasty. Circulation 1995;91:979-89.[Abstract/Free Full Text]
  • Kip KE, Faxon DP, Detre KM, Yeh W., Kelsey SF, Currier JW Coronary angioplasty in diabetic patients. The National Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry. Circulation 1996;94:1818-25.[Abstract/Free Full Text]
  • Abizaid A., Kornowski R., Mintz GS et al. The influence of diabetes mellitus on acute and late clinical outcomes following coronary stent implantation. J Am Coll Cardiol 1998;32:584-9.[Abstract/Free Full Text]
  • Elezi S., Kastrati A., Pache J. et al. Diabetes mellitus and the clinical and angiographic outcome after coronary stent placement. J Am Coll Cardiol 1998;32:1866-73.[Abstract/Free Full Text]
  • Barsness GW, Peterson ED, Ohman EM et al. Relationship between diabetes mellitus and long-term survival after coronary bypass and angioplasty. Circulation 1997;96:2551-6.[Abstract/Free Full Text]
  • Elezi S., Kastrati A., Neumann FJ, Hadamitzky M., Dirschinger J., Schomig A. Vessel size and long-term outcome after coronary stent placement. Circulation 1998;98:1875-80.[Abstract/Free Full Text]
  • Kastrati A., Schomig A., Elezi S. et al. Predictive factors of restenosis after coronary stent placement. J Am Coll Cardiol 1997;30:1428-36.[Abstract]
  • Carrozza JP Jr, Kuntz RE, Fishman RF, Baim DS Restenosis after arterial injury caused by coronary stenting in patients with diabetes mellitus. Ann Intern Med 1993;118:344-9.[Abstract/Free Full Text]
  • UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with Type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Pyörälä K., Pedersen TR, Kjekshus J., Faergeman O., Olsson AG, Thorgeirsson G. Cholesterol lowering with simvastatin improves prognosis of diabetic patients with coronary heart disease. A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S). Diabetes Care 1997; 20:614-20.[Abstract]
  • Hansson L., Zanchetti A., Carruthers SG et al. Effects of intensive blood pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998;351:1755-62.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Goldberg RB, Mellies MJ, Sacks FM et al. Cardiovascular events and their reduction with pravastatin in diabetic and glucose-intolerant myocardial infarction survivors with average cholesterol levels. Subgroup analyses in the Cholesterol And Recurrent Events (CARE) trial. Circulation 1998;98: 2513-9.[Abstract/Free Full Text]
  • Laakso M. Insulin resistance and cardiovascular disease. Br J Diabetes Vasc Dis 2002;2(suppl):S7-S9.
  • Kemnitz JP, Elson DF, Roecker EB et al. Pioglitazone increases insulin sensitivity, reduces blood glucose, insulin, and lipid levels, and lowers blood pressure in obese, insulin-resistant rhesus monkeys. Diabetes 1994;43: 204-11.[Abstract]
  • Nolan JJ, Ludvik B., Beerdsen P. et al. Improvement in glucose tolerance and insulin resistance in obese subjects treated with troglitazone. N Engl J Med 1994;331:1188-93.[Abstract/Free Full Text]
  • Maggs DG, Buchanan TA, Burant CF et al. Metabolic effects of troglitazone monotherapy in Type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Ann Intern Med 1998;128:176-85.[Abstract/Free Full Text]
  • Mykkänen L. Prevention of coronary heart disease in Type 2 diabetes. Int J Clin Pract 2000;suppl13:40-5.
  • Koshiyama H., Shimono D., Kuwamura N., Minamikawa J., Nakamura Y. Rapid communication: inhibitory effect of pioglitazone on carotid arterial wall thickness in Type 2 diabetes. J Clin Endocr Metab 2001;86:3452-6.[Abstract/Free Full Text]
  • Haffner SM, Greenberg A., Weston W. et al. Effects of rosiglitazone treatment on levels of C-reactive protein and MMP9 in patients with type 2 diabetes. American Heart Association Scientific Sessions; November 11-14, 2001; Anaheim, California. Poster 44, Abstract 565.
  • Lazar MA Progress in cardiovascular biology: PPAR for the course. Nature Medicine 2001;7:23-4.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]

The British Journal of Diabetes & Vascular Disease, Vol. 2, No. 1 suppl, S4-S8 (2002)
DOI: 10.1177/14746514020020010201
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This Article
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