Diabetes Raises Fatal Heart Attack Risk by 50%

People with diabetes are 50% more likely to die of a heart attack, according to a large population study.

While the link between heart disease and diabetes has been well-known, researchers at the University of Leeds have pinned down the precise risk after evaluating records from 700,000 patients admitted to the hospital for a heart attack between January 2003 and June 2013.

Of this group, 121,000 had diabetes.

Researchers controlled for age, gender, and other differences—including the quality of medical care—and the difference of having diabetes emerged as a huge factor in whether a patient survived.

Among those who experienced a ST elevation myocardial infarction, or STEMI heart attack —in which the coronary artery is completely blocked—those with diabetes were 56% more likely to die from the episode.

Those with a non-STEMI attack, in which the coronary artery is partially blocked, were still 39% more likely to die if they had diabetes.

The importance of cardiovascular (CV) protection in diabetes care is paramount among regulators who monitor medications for diabetes and obesity. Since 2008, the FDA has required exhaustive, multi-year trials of new therapies to ensure they do not produce long-term CV harms.

Since last year, 2 therapies—empagliflozin and liraglutide—have been shown to produce come CV benefits without other apparent effects. The importance of preventing CV mortality in diabetes care was discussed by an expert panel convened by The American Journal of Managed Care this spring, and can be found here.

Results for liraglutide were presented at the recent 76^th Scientific Sessions of the American Diabetes Association in New Orleans, Louisiana. The therapy was found to reduce CV death risk by 22%.

In the new study published this week, lead researcher Chris Gale, PhD, MSc, FRCP, consultant cardiologist and associate professor at the University of Leeds School of Medicine, said the results offer “robust evidence” that diabetes is a long-term contributing factor among those who suffer fatal heart attacks.

“Although these days people are more likely than ever to survive a heart attack, we need to place greater focus on the long-term effects of diabetes in heart attack survivors,” he said.

Gale said the next step would be to figure out why diabetes raises the risk of cardiac death so significantly.

Reference

doi:10.1136/jech-2016-207402

Alabas OA, Hall M, Dondo TB, et al. Long-term excess mortality associated with diabetes following acute myocardial infarction: a population based cohort study [published online June 15, 2016]. J Epidemiol Community Health. .