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heartJune 29 2016

A new study has shown the importance of managing type 2 diabetes to help reduce the risk of heart attack fatalities. Long term data indicates that diabetes can raise the risk of death among people who have an heart attack by 56%.

The University of Leeds study has looked at data representing 1.94 million person-years follow-up covering the period 2003 to 2013, and including over 120,000 patients with diabetes. There were 188,000 deaths, representing 26.7% of all patients in the total cohort, but “unadjusted, all-cause mortality was higher among patients with than without diabetes (35.8% vs 25.3%).”

Researchers looked specifically at ST-elevation myocardial infarctions (STEMI) where the coronary artery is completely blocked. Taking into account factors such as age, sex, and co-morbidities, people with diabetes were 56 % more likely to have died if they had experienced a STEMI heart attack. “They were 39% more likely to have died if they had a non-ST elevation myocardial infarction (NSTEMI) heart attack – in which the artery is partially blocked - than those without diabetes.”

Lead researcher Dr Chris Gale, Consultant Cardiologist and Associate Professor, said: “These results provide robust evidence that diabetes is a significant long-term population burden among patients who have had a heart attack. 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.

“The partnership between cardiologists, GPs and diabetologists needs to be strengthened and we need to make sure we are using established medications as effectively as possible among high-risk individuals.”

Commenting on the findings, Dr Mike Knapton, Associate Medical Director at the British Heart Foundation, said: “We knew that following a heart attack, you are less likely to survive if you also have diabetes. However, we did not know if this observation was due to having diabetes or having other conditions which are commonly seen in people with diabetes.

“This paper is the first to conclusively show that the adverse effect on survival is linked to having diabetes, rather than other conditions people with diabetes may suffer from. “This research highlights the need to find new ways to prevent coronary heart disease in people with diabetes and develop new treatments to improve survival after a heart attack.”

Dr Anna Morris, Head of Research Funding at Diabetes UK, added: “While researchers tackle this issue, we know that managing diabetes effectively can reduce the risk of developing cardiovascular disease. This includes eating healthily, keeping active and taking medications as prescribed by your doctor.

“It’s essential that people with diabetes get the support they need to do this effectively, and that we continue to fund research across the UK aimed at preventing the onset of complications in the first place.”

Links:

University of Leeds announcement

OA Alabas et al. 'Long-term excess mortality associated with diabetes following acute myocardial infarction: a population-based cohort study'. J Epidemiol Community Health. 2016. Published online first June 15 2016

BHF comment

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