CMAJ • January 6, 2009; 180 (1). doi:10.1503/cmaj.071027.
© 2009 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Research

Comparison of prognosis for men with type 2 diabetes mellitus and men with cardiovascular disease

Gilles R. Dagenais, MD, Annie St-Pierre, PhD, Patrick Gilbert, MD, Benoît Lamarche, PhD, Jean-Pierre Després, PhD, Paul-Marie Bernard, MSc and Peter Bogaty, MD

From the Institut universitaire de cardiologie et pneumologie (Dagenais, St-Pierre, Després, Bogaty), the Institut de nutraceutiques et aliments fonctionnels (Lamarche) and the Faculté de médicine (Bernard), Université Laval, Québec, Que.; and the Centre Hospitalier de l'Université de Montréal (Gilbert), Montréal, Que.

Correspondence to: Dr. Gilles R. Dagenais, Institut universitaire de cardiologie et pneumologie, 2725, chemin Ste-Foy, Québec QC G1V 4G5; fax 418 656-4683; gilles.dagenais{at}crhl.ulaval.ca

Background: People with type 2 diabetes mellitus are at high risk for cardiovascular disease. In some studies, the mortality rate among people with this condition has been equivalent to that among people with cardiovascular disease. We compared cardiovascular mortality between incident cases of diabetes and cardiovascular disease.

Methods: The study population was part of a random sample of 4376 men from Quebec, Canada, aged 35 to 64 years, who did not have cardiovascular disease in 1974 and who were followed until 1998. Three groups of incident cases were identified: diabetes without cardiovascular disease, first cardiovascular event (myocardial infarction, unstable angina or stroke) without diabetes, and both cardiovascular disease and diabetes. These cases were age-matched to a control group without diabetes or cardiovascular disease.

Results: During the 24-year follow-up period, new diabetes without cardiovascular disease was documented in 137 men. A first cardiovascular event without diabetes was documented in 527 men. Relative to the 627 controls, men with 1 of the 2 diseases of interest had higher cardiovascular mortality (age-adjusted relative risk [RR] 3.11, 95% confidence interval [CI] 1.96–4.92) for those with diabetes and 4.46 (95% CI 3.15–6.30) for those with cardiovascular disease). However, within the first 5 years after diagnosis, men with cardiovascular disease had higher cardiovascular mortality than men with diabetes (age-adjusted RR 2.03, 95% CI 1.01–4.08).

Interpretation: Men with isolated type 2 diabetes and men with isolated cardiovascular disease had similar cardiovascular mortality rates several years after initial diagnosis of either condition. These findings reinforce the need to prevent and optimally manage diabetes and cardiovascular disease.


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Highlights
Can. Med. Assoc. J. 2009 180: 5. [Full Text] [PDF]

Dans ce numéro
Can. Med. Assoc. J. 2009 180: 7. [Full Text] [PDF]