The prevalence of coronary heart disease in Type 2 diabetic patients in Italy: the DAI study

Diabet Med. 2004 Jul;21(7):738-45. doi: 10.1111/j.1464-5491.2004.01230.x.


Aims: Type 2 diabetes is associated with at least a twofold increase in risk of coronary heart disease (CHD). We aimed to estimate the prevalence of CHD in the population of Type 2 diabetics cared for by the Italian network of outpatient diabetic units.

Methods: The DAI (Diabetes and Informatics study group, Italian Association of Diabetologists, and Italian National Institute of Health) study is a multicentre cohort study of patients with Type 2 diabetes. Patients were classified as having CHD if they had: (i) a history for hospital admission for either an acute myocardial infarction (AMI) or angina; (ii) a positive ECG for prior AMI or angina; (iii) a positive history for coronary artery bypass graft; or (iv) a positive history for percutaneous transluminal coronary angioplasty.

Results: A cohort of 19 468 patients was analysed: 3157 patients had CHD. The majority of events (80%) had occurred after the diagnosis of diabetes and were considered in the CHD prevalence estimate. The prevalence of CHD, adjusted by age and sex, was 9.9%: 11.0% male and 9.0% female. Angina without AMI occurred in 1306 patients; this condition was more frequent in females while a documented AMI was more frequent in males. Therapeutic procedures were performed more frequently in males. A positive association with CHD was found for gender, age at visit, duration of diabetes, hypertension, relatives with CHD, tryglicerides and microvascular complications.

Conclusions: The prevalence of CHD in this cohort is lower than previously reported; nevertheless, patients attending the diabetic care units may not be fully representative of the general diabetic population in Italy. Revascularization is less frequent in females than in males; microvascular complications and a worse metabolic control are significantly associated with CHD.

MeSH terms

  • Age Factors
  • Aged
  • Angina Pectoris / epidemiology
  • Cohort Studies
  • Coronary Disease / epidemiology*
  • Coronary Disease / therapy
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetic Angiopathies / epidemiology*
  • Diabetic Angiopathies / therapy
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Sex Factors