Coronary Heart Disease Incidence in NIDDM Patients In The Helsinki Heart Study

Publisher Website
Google Scholar
Abstract
Objective: To determine coronary heart disease (CHD) incidence among dyslipidemic subjects with non-insulin-dependent diabetes mellitus (NIDDM) and to assess the effect of lipid-modifying treatment on serum and lipoprotein lipids and the CHD incidence in these patients. Research Design and Methods: Of the 4081 men participating in the Helsinki Heart Study, a coronary primary prevention trial with gemfibrozil in middle-aged men with high non-high-density lipoprotein (HDL) cholesterol (> 5.2 mM; 200 mg/dL), 135 had NIDDM at entry. The incidence of definite myocardial infarction and cardiac death and changes in serum and lipoprotein lipids were determined during the 5-yr trial in the NIDDM patients and compared with those observed in nondiabetic trial participants. Results: Compared with nondiabetic subjects, NIDDM patients had lower HDL cholesterol (P < 0.001), higher triglyceride concentration (P < 0.0001), and greater body mass index (P < 0.001), there were more hypertensive patients (P < 0.001) among them. The incidence of myocardial infarction and cardiac death was significantly higher among diabetic than nondiabetic participants (7.4 vs. 3.3%, respectively, P < 0.02). CHD incidence in the gemfibrozil-treated diabetic men (n = 59) was 3.4% compared with 10.5% in the placebo group (NS). In multivariate analysis, diabetes (P < 0.05), age (P < 0.0001), smoking (P < 0.0001), low HDL cholesterol (P < 0.05), and high low-density lipoprotein cholesterol (P < 0.005) were independently related to CHD incidence. Gemfibrozil-induced serum and lipoprotein lipid changes in diabetic patients were similar to those observed in nondiabetic subjects. Conclusions: Compared with similarly dyslipidemic nondiabetic subjects, patients with NIDDM are at markedly increased risk of CHD. This elevated risk can be somewhat reduced by gemfibrozil.

This publication has 0 references indexed in Scilit: