In Reply: In response to Drs Srinivasan and Bhagra, we agree that aggressive modification of risk factors that may result in prolonged survival should be the main long-term management goal in patients who present with unstable ischemic heart disease. An emphasis on secondary prevention with medical therapy is vital for all patients, and perhaps even more so for patients with diabetes. New approaches to ensure adherence to clinical guideline recommendations for proven therapies may be of benefit.
Donahoe SM, Stewart GC, Antman EM. Diabetes and Mortality Risk After Acute Coronary Syndromes—Reply. JAMA. 2007;298(20):2367-2368. doi:10.1001/jama.298.20.2368-a