Heart 1997;78:527-529 ( December )
Editorial
Coronary artery disease and diabetes
| The first 150 words of the full text of this article appear below. |
Patients with diabetes form a substantial proportion of patients with coronary artery disease.1 In some respects, the assessment, management, and outcome of these patients is different from patients without diabetes. This article outlines these differences in patients with symptomatic coronary disease and then focuses on the problems of managing high risk asymptomatic patients with diabetes. Should we and can we reliably identify these patients? Once identified, are they likely to benefit from intervention?
Diabetes is a strong and independent risk factor for the presence
of coronary disease increasing the risk, particularly in women, between
twofold and fourfold.2 In patients with diabetes, coronary
disease is more extensive and severe, and cardiovascular death is three
times more common than in non-diabetic patients.3 In
patients with non-insulin dependent diabetes, a proportion of the
increased risk can be explained by an excess and clustering of
established cardiovascular risk factors. The mechanisms accounting for
the
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