In a 1998 Finnish cohort study, the seven-year risk of MI from diabetes was found to be the same as that of having a history of previous MI (N Engl J Med. 1998;339:229-234; available at content.nejm.org/cgi/content/full/339/4/229, accessed August 12, 2009). These findings were not confirmed in a 2002 Scottish study (BMJ. 2002;324:939-942; available at www.bmj.com/cgi/content/full/324/7343/939?view=long&pmid=11964337, accessed August 12, 2009). A recent systematic review and meta-analysis of 13 studies with 45,108 patients followed for a mean of 13.4 years found that diabetes alone is a significantly weaker predictor of cardiovascular outcomes (Diabet Med. 2009;26:142-148). Patients with diabetes but no prior MI had a 43% lower risk of suffering total coronary heart disease events compared with patients with previous MI but no history of diabetes (summary odds ratio 0.56, 95% confidence interval 0.53-0.6).
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