The prognosis for Type 2 diabetic patients with heart disease - A 10-year observation study of 385 patients

The objective was to study the development and progression of heart disease in type 2 diabetic patients and to evaluate the influence of revascularisa tion procedures on its outcome. A 10-year observation study in 385 patients attending a hospital-based outpatient clinic was performed. A total of 156 /385 patients developed myocardial infarction (n = 68), angina (n = 44), he art failure (n = 34) or died (n = 109). A high mortality was seen in patien ts with myocardial infarction (73%) and heart failure (71%), in contrast, t o patients with angina (25%). Thirty patients had a coronary angiography be cause of angina, out of which 23 were revascularised. Four (17%) of patient s with bypass surgery or angioplasty died compared with 57 (67%) of the pat ients with no intervention (p < 0.001). The occurrence of myocardial infarc tion was associated with age (p < 0.0001), and mean systolic (p < 0.05) and diastolic (p < 0.05) blood pressure and degree of albuminuria at entry (p < 0.05). Heart failure was associated with age (p < 0.0001), and mean HbA(1 c) levels (p < 0.05), while angina was associated with age only (p < 0.05). Death was associated with age (p < 0.0001), diabetes duration (p < 0.05), mean diastolic blood pressure (p < 0.05), and degree of albuminuria at entr y (p < 0.0001). This study shows a high incidence of heart disease in patie nts with type 2 diabetes. The prognosis was better in patients who had had a revascularisation procedure. Thus, a more active attitude towards revascu larisation may potentially improve the prognosis for type 2 diabetic patien ts with atherosclerotic heart disease. (C) 2000 Elsevier Science Inc. All r ights reserved.