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