C-reactive-protein is a marker of long-term development of HF and mortality in patients with acute MI and provides prognostic information beyond that provided by conventional risk factors and the degree of left ventricular systolic dysfunction.

No abstract

Background-Stress hyperglycemia in patients with acute myocardial infarction has been associated with increased mortality. Most studies looked at the relationship between admission glucose (AG) and outcome; limited information is available about the clinical significance of fasting glucose (FG

The development of anaemia during hospitalization for AMI is frequent and is associated with an increased long-term mortality.

Patients with diabetes presenting with acute myocardial infarction (AMI) have an increased rate of death and heart failure. Patients with diabetes homozygous for the haptoglobin (Hp) 1 allele (Hp 1-1) develop fewer vascular complications. We tested the hypothesis that Hp type is related to the outcome of patients with diabetes presenting with AMI. We prospectively assessed the relationship between Hp type and 30-day mortality and heart failure in 1,437 patients with AMI (506 with diabetes). Multivariate logistic regression identified a significant interaction between Hp type and diabetes status on these outcome measures. Hp type was not related to outcome among patients without diabetes. In contrast, Hp 1-1 was associated with a strong protective effect with regard to the primary end point of death (OR 0.14, P ‫؍‬ 0.015) and for death and heart failure (OR 0.35; 95% CI 0.15-0.86, P ‫؍‬ 0.018) among patients with diabetes. Finally, among patients with diabetes, Hp 1-1 was associated with smaller infarct size. This study demonstrates that in patients with diabetes and AMI, the Hp type is an important determinant of clinical outcome and infarct size. Diabetes 54:2802-2806, 2005 P atients with diabetes presenting with acute myocardial infarction (AMI) have a poor in-hospital and long-term prognosis (1). The excess in-hospital mortality and morbidity correlates primarily with an increased incidence of congestive heart failure (1,2), with heart failure developing at about twice the rate in patients with diabetes than in patients without diabetes(1). Diabetes is also a risk factor for cardiogenic shock in the setting of acute ischemic syndromes (3).The susceptibility to diabetic complications is partially controlled by complex unknown genetic factors (4,5). One such genetic factor appears to be a functional allelic polymorphism in the haptoglobin (Hp) gene (6 -11). In humans, there are two major alleles, denoted 1 and 2, for the Hp gene (12,13). We have recently shown that patients who are homozygous for the Hp 1 allele (Hp 1-1) are at a lower risk of developing both microvascular (6,7,10) and macrovascular complications associated with diabetes (8,9,14). We have proposed that susceptibility to diabetic vascular disease conferred by the Hp type is the result of marked differences in the antioxidant protection against hemoglobin-induced oxidation provided by the Hp 1 and Hp 2 allelic protein products (15-17). Specifically, we have shown in vitro and in vivo in mice genetically modified at the Hp locus that the Hp 1 and Hp 2 protein products differ in a diabetes-dependent fashion in their ability to prevent the release of redox active iron from hemoglobin and in the rate at which the hemoglobin-Hp complex is cleared via the CD163 scavenger receptor on monocyte/macrophages (15)(16)(17).In the present study, we sought to prospectively test the hypothesis that Hp type is related to the outcome of patients presenting with AMI. Because previous studies have shown that the effect of Hp type might be especially important in pat...