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Elderly Diabetics With Peripheral Arterial Disease and No Coronary Artery Disease Have a Higher Incidence of New Coronary Events Than Elderly Nondiabetics With Peripheral Arterial Disease and Prior Myocardial Infarction Treated With Statins and With No Lipid-Lowering Drug

¹ Cardiology and Geriatrics Divisions, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla.
² Department of Medicine, University of Texas Medical School, Houston.

Background. We report data showing the incidence of new coronary events in diabetics with prior myocardial infarction (MI), nondiabetics with prior MI, diabetes with no coronary artery disease (CAD), and nondiabetics with no CAD who were treated with and without statins.

Methods. We investigated—in an observational prospective study of 274 diabetics and 386 nondiabetics with peripheral arterial disease, mean age years, and a serum low-density lipoprotein cholesterol level of ≥125 mg/dl—the incidence of new coronary events in diabetics with prior MI, nondiabetics with prior MI, diabetics with no CAD, and nondiabetics with no CAD who were treated with and without statins. Follow-up was months.

Results. In patients treated with statins, the incidence of new coronary events was 73% in diabetics with prior MI (group 1), 37% in nondiabetics with prior MI (group 2), 57% in diabetics with no CAD (group 3), and 27% in nondiabetics with no CAD (group 4). In patients treated with no lipid-lowering drug, the incidence of new coronary events was 91% in diabetics with prior MI (group 5), 72% in nondiabetics with prior MI (group 6), 86% in diabetics with no CAD (group 7), and 52% in nondiabetics with no CAD (group 8). Significant p values were for group 1 versus 2, group 7 versus 8, and group 2 versus 6; for group 3 versus 4; for group 3 versus 7; for group 5 versus 6; for group 4 versus 8; for group 1 versus 5; for group 2 versus 3; and for group 6 versus 7.

Conclusions. In patients treated with and without statins, diabetics with no CAD had a higher incidence of new coronary events than did nondiabetics with prior MI.