Increased Mortality Rate Observed in Patients with Type 2 Diabetes, Coronary Artery Disease

Findings from a recent study suggest that patients with type 2 diabetes and coronary artery disease have a high risk of death that may be associated with medication use.

The study, presented at the American Diabetes Association annual meeting, discovered that 1 in 4 patients with type 2 diabetes admitted to the hospital for congestive heart failure died within 18 months.

"Type 2 diabetes accompanied by an acute coronary syndrome needs much more attention, especially in order to prevent yet another major cardiac event," said principal researcher William B. White, MD.

Patients with type 2 diabetes have an increased risk of heart disease compared with the general population due to obesity, hypertension, elevated cholesterol, and other illnesses linked to both diseases. Insulin can also damage the heart, according to the study.

The researchers included 5380 patients from the EXAMINE trial with type 2 diabetes who had major acute coronary syndrome. The trial evaluated the diabetes drug alogliptin (Nesina), which is a DPP-4 inhibitor.

In the EXAMINE trial, patients either received alogliptin or placebo. The researchers found the drug had no impact on cardiovascular death, heart attack, or stroke after 3 years. In the current study, researchers found that people with type 2 diabetes admitted to the hospital for heart failure and taking aloglipin had a 24% chance of death, while patients taking placebo had a 28% chance, according to the study.

"It's a very dramatic result," said Dr White. "A person with type 2 diabetes requiring hospitalization for heart failure in the EXAMINE trial was a harbinger of a very poor outcome."

Researchers are currently trying to find patterns of biomarkers that could provide signs of an increased risk for another cardiovascular event.

Investigators concluded that congestive heart failure is avoidable for patients with type 2 diabetes; however, heart failure outcomes should receive as much attention as stroke, heart attack, and unstable angina.