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Combination Therapy Reduces Risk of Heart Disease in Diabetic Patients
March 21, 2002

ATLANTA, Georgia (ACC) -- Compared to nondiabetics, diabetic patients are at significantly higher risk for ST-elevation myocardial infarction. But a new study reported at a news conference on Monday, March 18, 2002, shows that the increased use of beta-blockers and ACE inhibitors over the years has improved survival of these patients.

“We discovered that patients with diabetes who were treated with the combination therapy had less incidence of recurring heart attack, less need for urgent revascularization, and fewer incidents of malignant ventricular arrhythmia,” said Hitlander S. Gurm, MD, from the Cleveland Clinic Foundation.

In their study, the researchers analyzed diabetic patients enrolled the in GUSTO I and III trials and compared them against patients enrolled in the GUSTO V trial, which was completed in 2001. Diabetic patients in GUSTO V, they found, were more likely to receive the combination therapy and have better 30-day survival than diabetic patients in the earlier trials who did not receive the combination therapy. Also, people with diabetes who did not receive combination therapy were nearly one and a half to two times as likely to have a second heart attack.

The study also showed that about 13 percent of the patients with diabetes in GUSTO V who did not receive combination therapy required urgent coronary artery bypass graft surgery, angioplasty, or stenting within seven days, compared with 10.9 percent of the diabetics who received combination therapy.

The extent of the problem of heart disease among diabetic patients, and an alarming finding that most diabetics don’t even consider cardiovascular disease to be a serious risk factor associated with their disease, was revealed in the findings of a new survey commissioned by the American Diabetes Association (ADA) and the ACC. The survey—the first activity under the new partnership between the ADA and ACC and dubbed Make the Link!—showed that nearly 70 percent of the more than 2,000 patients surveyed did not even consider cardiovascular disease to be a serious risk associated with their diabetes.

“Sixteen million people in the U.S. are living with diabetes, and while there is widespread concern about the other complications of the disease—blindness, kidney failure, and amputation—the most life-threatening complications of diabetes are heart disease and stroke,” said John Buse, MD, chairman of the ADA Cardiovascular Disease Initiative and director of the University of North Carolina Diabetes Care Center. He announced results of the survey at the news conference.

The ADA and ACC have partnered on the Make the Link! program in an effort to educate physicians and health care providers about the link between diabetes and cardiovascular disease. Through this initiative, the groups will promote prevention of cardiovascular disease in people with diabetes through a better understanding of risk factor management.

“People with diabetes, especially those in the highest-risk groups, simply are not making the link that heart disease and stroke are associated with their disease,” Dr. Buse said. “Now that we have this data, we can and we must find ways to educate people with diabetes about their risk for heart disease. Make the Link! is a multidisciplinary approach to solving this problem.”

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