Chapter 21. Cardiac Complications and Management

  1. William H. Herman3,
  2. Ann Louise Kinmonth4,
  3. Nicholas J. Wareham5 and
  4. Rhys Williams6
  1. Anthony S. Wierzbicki1 and
  2. Simon R. Redwood2

Published Online: 12 JAN 2010

DOI: 10.1002/9780470682807.ch21

The Evidence Base for Diabetes Care, Second Edition

The Evidence Base for Diabetes Care, Second Edition

How to Cite

Wierzbicki, A. S. and Redwood, S. R. (2010) Cardiac Complications and Management, in The Evidence Base for Diabetes Care, Second Edition (eds W. H. Herman, A. L. Kinmonth, N. J. Wareham and R. Williams), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470682807.ch21

Editor Information

  1. 3

    Department of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI, USA

  2. 4

    General Practice and Primary Care Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

  3. 5

    MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK

  4. 6

    School of Medicine, Swansea University, Swansea, UK

Author Information

  1. 1

    Department of Chemical Pathology, Guy's and St Thomas' Hospitals, London, UK

  2. 2

    Department of Cardiology Gu's and St Thomas' Hospitals, London, UK

Publication History

  1. Published Online: 12 JAN 2010
  2. Published Print: 19 FEB 2010

ISBN Information

Print ISBN: 9780470032749

Online ISBN: 9780470682807



  • coronary heart disease;
  • cardiovascular risk factors;
  • cardiac disease management;
  • diabetes


Diabetes is associated with multiple abnormalities in cardiovascular risk factors that all predispose to increased rates of coronary heart disease. Coronary heart disease rates in diabetes are increased 2–4-fold and diabetes is associated with greater rates of mortality for both acute coronary syndromes and cardiac dysfunction and failure due to the associated cardiac autonomic neuropathy and arrhythmias. Given the high prevalence of coronary heart disease in diabetes, investigations should be pursued aggressively to identify significant disease even in the face of weak presenting symptoms and signs. Management should include aggressive treatment of cardiovascular risk factors and percutaneous coronary intervention with a presumption towards use of drug-eluting stents or coronary bypass grafting as these offer improved outcomes in this patient group