MORTALITY FROM CORONARY HEART DISEASE IN SUBJECTS WITH AND WITHOUT TYPE 2 DIABETES MORTALITY FROM CORONARY HEART DISEASE IN SUBJECTS WITH TYPE 2 DIABETES AND IN NONDIABETIC SUBJECTS WITH AND WITHOUT PRIOR

betes is associated with a marked increase in the risk of coronary heart disease. It has been debated wheth-er patients with diabetes who have not had myocar-dial infarctions should be treated as aggressively for cardiovascular risk factors as patients who have had myocardial infarctions. Methods To address this issue, we compared the seven-year incidence of myocardial infarction (fatal and nonfatal) among 1373 nondiabetic subjects with the incidence among 1059 diabetic subjects, all from a Finnish population-based study. Results The seven-year incidence rates of myo-cardial infarction in nondiabetic subjects with and without prior myocardial infarction at base line were 18.8 percent and 3.5 percent, respectively (P<0.001). The seven-year incidence rates of myocardial infarc-tion in diabetic subjects with and without prior myo-cardial infarction at base line were 45.0 percent and 20.2 percent, respectively (P<0.001). The hazard ra-tio for death from coronary heart disease for diabetic subjects without prior myocardial infarction as com-pared with nondiabetic subjects with prior myocar-dial infarction was not significantly different from 1.0 (hazard ratio, 1.4; 95 percent confidence interval, 0.7 to 2.6) after adjustment for age and sex, suggesting similar risks of infarction in the two groups. After further adjustment for total cholesterol, hyperten-sion, and smoking, this hazard ratio remained close to 1.0 (hazard ratio, 1.2; 95 percent confidence inter