CHICAGO — Five-year mortality in diabetes patients with stable angina is twice as high as in stable angina patients without diabetes, according to a large, prospective, real-world, clinical practice registry.
Of 2,002 consecutive patients with stable angina and newly diagnosed, angiographically confirmed coronary artery disease enrolled in the German 50-center STAR Registry, 26% had diabetes. Their 5-year mortality was 29%, compared with 15% in the nondiabetic patients, Dr. Anselm K. Gitt reported at the meeting.
The patients with diabetes were on average older and had significantly higher rates of multivessel disease, impaired left ventricular function, and comorbid conditions than their counterparts without diabetes. But even after these factors were adjusted for in a multivariate Cox regression analysis, diabetes remained an independent predictor of mortality associated with a striking 1.8-fold increased risk, second only to the 2.5-fold risk conferred by a left ventricular ejection fraction of less than 40%, according to Dr. Gitt, senior staff physician at the Ludwigshafen (Germany) Heart Center.
Other independent predictors of 5-year mortality in STAR participants with stable angina were prior stroke, with a 1.5-fold increased risk; prior MI, with a 1.4-fold risk; age, which increased mortality risk by 7% per year; and female gender, which was associated with a significant 25% protective effect against mortality.
Dr. Gitt declared having no relevant financial interests.