Diabetes Isn't Equivalent to Past Coronary Heart Disease as a Risk Factor for Future CHD Events

For many years, patients with diabetes and no known coronary heart disease (CHD) were thought to have the same risk for future myocardial infarction (MI) as did patients with known CHD. Studies supporting this assertion had important limitations, and many now are dated. The 2013 American College of Cardiology/American Heart Association risk assessment guideline moved away from treating prevalent CHD and diabetes as “risk equivalents,” and defined diabetes as only one of several factors that contribute to cardiovascular risk (NEJM JW Gen Med Dec 15 2013 and J Am Coll Cardiol 2014; 63:2935).

To quantify the effects of diabetes and current CHD on future CHD risk more precisely, researchers studied prevalent diabetes and past CHD (defined as his…