Among the diabetic patients, 755 (84%) died during follow-up, compared with 3,200 (70%) among the non-diabetic patients (Figure 1). Crude one-month and one-year mortality rates for patients without diabetes were 5% and 23%, respectively. The corresponding numbers for patients with diabetes were 7% and 31%. When evaluated in a univariate model, the risk ratio (RR) of death in diabetic patients compared with non-diabetic patients was 1.5 (95% confidence interval [CI] 1.4 to 1.6, p < 0.0001). To investigate whether the increased mortality in patients with diabetes reflected a higher prevalence of concomitant risk factors, a multivariate analysis, including age, gender, smoking, history of ischemic heart disease, previous MI, arterial hypertension, atrial fibrillation, NYHA functional class, and WMI as covariates, was performed. The RR of death in diabetic patients in this model was 1.5 (95% CI 1.3 to 1.6, p < 0.0001) (Table le4). Unfortunately, information on body mass index was missing for 791 patients (14%); therefore, this variable was not included in the multivariate model. Adding body mass index to the model, however, did not alter the results significantly. Similarly, data on new-onset CHF was missing for 437 patients (8%), and the addition of this variable, likewise, did not change the independent impact of diabetes on mortality (RR 1.4, p < 0.0001), nor was the result changed significantly by the addition of treatment with ACE inhibitors, beta-blockers, or digoxin or whether or not the patients were included in the randomized DIAMOND study. In the former multivariate model (including randomization status and treatment with ACE inhibitors, beta-blockers, or digoxin) and in a model including only age, diabetes, and gender, a significant interaction between diabetes and gender was found (p = 0.03 and p = 0.01, respectively). Consequently, a new multivariate model including the same nine covariates, besides separate variables for diabetes in men and diabetes in women, was created. This model revealed that the interaction between diabetes and gender reflected that diabetes increased the mortality risk more in women than in men, with the RR for diabetic men being 1.4 (95% CI 1.3 to 1.6, p < 0.0001) and 1.7 for diabetic women (95% CI 1.4 to 1.9, p < 0.0001). In patients without diabetes, males had a higher mortality, but the opposite was found for diabetic patients, where the females had the highest mortality rate (Figure 2). During follow-up, 70% of the non-diabetic men and 69% of the non-diabetic women died. The corresponding numbers for the diabetic men and women were 83% and 85%. Other significant interactions between diabetes and the remaining parameters in the multivariate model were not found.