Effect of diabetes on the clinical characteristics and prognosis of patients with chronic ischemic heart disease. The CIBAR study.

The aim of this study was to evaluate the effect of diabetes mellitus on the prognosis of patients with chronic ischemic heart disease. The multicenter prospective cohort study involved 1108 outpatients with ischemic heart disease whose clinical characteristics were recorded by 69 primary care physicians. Morbidity and mortality were recorded during a mean follow-up period of 6.9 months. Overall, 29% of patients were diabetic; they were older than non-diabetics, presented with more risk factors, had poorer blood pressure control, and had more comorbid conditions. In addition, diabetics were more likely to be prescribed renin-angiotensin system blockers, calcium channel blockers, diuretics and lipid-lowering drugs. Cardiovascular mortality and hospitalization rates were higher in diabetics. On multivariate analysis, diabetes was found to be an independent predictor of a cardiovascular event (hazard ratio=1.81; 95% confidence interval, 1.17-2.82). Prognosis in chronic ischemic heart disease is relatively good, although it is worse in diabetics, which means that treatment and disease controls targets must be more rigorously applied in these patients.

Influencia de la diabetes en las características clínicas y el pronóstico de pacientes con cardiopatía isquémica crónica. Estudio CIBAR / Effect of diabetes on the clinical characteristics and prognosis of patients with chronic ischemic heart disease. The CIBAR study

Evaluamos el impacto de la diabetes mellitus (DM) en el pronóstico de pacientes con cardiopatía isquémica crónica (CIC). Estudio multicéntrico de cohortes prospectivas, en el que 69 médicos de atención primaria registraron características de 1.108 pacientes ambulatorios con CIC y analizaron la mortalidad y la morbilidad tras un seguimiento medio de 6,9 meses. Los diabéticos (29%) eran mayores que los no diabéticos, tenían más factores de riesgo, peor control de presión y más comorbilidades y recibían más bloqueadores del sistema renina-angiotensina, antagonistas del calcio, diuréticos e hipolipemiantes. La mortalidad y los ingresos por causa cardiovascular fueron mayores en los diabéticos. En el análisis multivariable, la DM fue un determinante independiente de eventos cardiovasculares (hazard ratio = 1,81; intervalo de confianza del 95%, 1,17-2,82). La CIC tiene un pronóstico relativamente benigno, aunque empeora en los diabéticos, por lo que en ellos el tratamiento y los objetivos de control han de ser más estrictos (AU)

The aim of this study was to evaluate the effect of diabetes mellitus on the prognosis of patients with chronic ischemic heart disease. The multicenter prospective cohort study involved 1108 outpatients with ischemic heart disease whose clinical characteristics were recorded by 69 primary care physicians. Morbidity and mortality were recorded during a mean follow-up period of 6.9 months. Overall, 29% of patients were diabetic; they were older than non-diabetics, presented with more risk factors, had poorer blood pressure control, and had more comorbid conditions. In addition, diabetics were more likely to be prescribed renin-angiotensin system blockers, calcium channel blockers, diuretics and lipid-lowering drugs. Cardiovascular mortality and hospitalization rates were higher in diabetics. On multivariate analysis, diabetes was found to be an independent predictor of a cardiovascular event (hazard ratio=1.81; 95% confidence interval, 1.17- 2.82). Prognosis in chronic ischemic heart disease is relatively good, although it is worse in diabetics, which means that treatment and disease controls targets must be more rigorously applied in these patients (AU)