Impact of Diabetes on Mortality in Patients With Myocardial Infarction and Left Ventricular Dysfunction

Murcia, Alvaro M.; Hennekens, Charles H.; Lamas, Gervasio A.; Jiménez-Navarro, Manuel F.; Rouleau, Jean L.; Flaker, Greg C.; Goldman, Steven; Skali, Hicham; Braunwald, Eugene; Pfeffer, Marc A.

doi:10.1001/archinte.164.20.2273

Cited by 140 publications

(94 citation statements)

References 44 publications

(50 reference statements)

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“…We propose two plausible explanations to account for the observation. First, the prevalences of predictors, including female gender, elderly, coronary artery disease risk factors of hypertension and diabetes, increased serum creatinine level, and elevated incidence of advanced Killip score upon presentation, which have been found to be associated with unfavorable clinical outcomes, 2,4,6,[25][26][27][28][29] were remarkably higher in patients with MVD compared with those with SVD in the current study. Moreover, both female gender and a Killip score of 3 were independently predictive of one-year mortality in MVD patients in this study.…”

Section: Figurementioning

confidence: 71%

Benefit of Revascularization in Non-Infarct-Related Artery in Multivessel Disease Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

et al. 2010

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SummaryThis study compared the prognosis of ST-elevation myocardial infarction (STEMI) in patients with multivessel disease (MVD) with that of single vessel disease (SVD) and investigated the revascularization benefit of noninfarct-related artery (IRA) in MVD patients undergoing primary percutaneous coronary intervention (PCI). Between 2002 and 2009, 1278 patients with STEMI underwent primary PCI. Of these patients, 717 (56.1%) with SVD (only IRA obstruction) were placed in group A, while 561 (43.9%) with MVD (Group B) were further categorized into group 1 (PCI for IRA) and group 2 (staged PCI for IRA+non-IRA). The results demonstrated a lower degree of successful reperfusion in IRA and higher 30-day and 1-year cumulative mortality rates in group B (P < 0.001). While there was no difference in successful reperfusion in IRA between group 1 and group 2, the 30-day and one-year cumulative mortality rates were higher in group 1. Multivariate analysis identified MVD as an independent predictor of 1-year mortality (P < 0.001). In conclusion, patients with subsequent PCI for MVD had better 30-day and 1-year outcomes than those with conservative treatment. (Int Heart J 2010; 51: 319-324)

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Section: Figurementioning

confidence: 71%

Benefit of Revascularization in Non-Infarct-Related Artery in Multivessel Disease Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

et al. 2010

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“…Both sulfonylureas [3,8,9], metformin [9,10] and insulin [9,[11][12][13] have been associated with increased mortality rate compared with diet. However, this might reflect a longer duration of diabetes and thus a more advanced stage of diabetes and/or a poorer glycaemic control among users of these drugs, rather than actual drug effects.…”

Section: Discussionmentioning

confidence: 99%

“…Data regarding outcome in cardiac patients using various types of glucose-lowering drugs are sparse and conflicting [3][4][5][6][7][8][9][10][11][12][13][14], and the existing studies have some limitations, including small and often nonrepresentative samples and shortcomings in the data analysis.…”

Section: Introductionmentioning

confidence: 99%

Type of preadmission glucose-lowering treatment and prognosis among patients hospitalised with myocardial infarction: a nationwide follow-up study

2008

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Aims/hypothesis We examined whether the type of preadmission glucose-lowering treatments explained differences in mortality rate and risk of readmission with myocardial infarction (MI) and heart failure following first-time hospitalisation for MI in patients with type 2 diabetes mellitus. Methods We conducted a nationwide population-based followup study among all Danish patients hospitalised with firsttime MI from 1996 to 2004. Data on use of glucose-lowering drugs and other medications, comorbidities, socioeconomic status, laboratory findings, readmission with MI and heart failure, and death were obtained from medical databases. We computed mortality rates and rates of MI and heart failure readmission, according to type of glucose-lowering treatment and used Cox's proportional hazards regression analysis to compute hazard ratios (HRs) as estimates of relative risks. Results We identified 8,494 MI patients with type 2 diabetes mellitus. The overall cumulative 30 day and 1 year mortality rates were 22.2 and 36.6%, respectively. Patients not receiving any glucose-lowering drugs (adjusted 30 day HR: 0.79, 95% CI: 0.57-1.10) and users of any combination (adjusted 30 day HR: 1.43, 95% CI: 0.98-2.09) had the lowest and highest mortality rates, respectively, when compared with users of sulfonylureas. We found that glycaemic control had no impact on the risk estimates in a subanalysis including biochemical laboratory data. We found no differences in the risk of new MI and heart failure between the different glucose-lowering agents. Conclusions/interpretation Type of preadmission glucoselowering treatment in monotherapy is not associated with substantial differences in prognosis following hospitalisation with MI. However, patients treated with any combination had increased mortality rates.

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“…Пре појаве тромболитичке терапије петогодишњи морта-литет болесника са инфарктом миокарда и дијабетесом је био 55%, а болесника са инфарктом, недијабетичара 30% 8 . Новија испитивања су показала да је десетогодишњи морталитет болесника са преболелим инфарктом и дијабетесом 44%, а недијабетичара 35% 9 .…”

Section: студија Mrfit (Multiple Risk Factor Interventionunclassified

Long-term mortality in patients with diabetes mellitus type 2 after acute myocardial infarction

Miljković¹

2014

Opsta med

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СажетакУвод. Инфаркт миокарда је најчешћи узрок смрти код болесника са дијабетесом и већина студија је показала да дијабетичари имају двоструко већи ризик умирања од инфаркта у поређењу са недијабетичарима.Циљ рада. Испитати удаљени морталитет болесника са преболелим акутним инфарктом миокарда у популацији болесника са дијабетес мелитусом и упоредити са морталитетом болесника са преболелим инфарктом без дијабетеса.Метод. Испитивањем je обухваћенo 135 болесника са преболелим инфарктом миокарда, просечне старости 55,4±9,6 година -51 (37,8%) болес-ник са дијабетес мелитусом тип 2 и 84 (62,2%) болесника без дијабетеса, као контролна група. Код свих болесника је урађено комплетно кардиолошко и хемодинамско испитивање, катетеризација срца са селективном коронарографијом, а код већине болесника и реваскуларизација миокарда аортокоронарним бајпасом или перкутаном коронарном интервенцијом. Почетак праћења болесника је био датум акутног инфаркта миокарда. Испитивањем су обухваћени само болесници после најмање месец дана од акутног инфаркта. Сви испитаници, са дијабетесом и без дијабетеса, праћени су просечно 84 месеца, односно 7 година.Резултати. Просечна старост болесника са дијабетесом и инфарктом миокарда је 57,1±8,7 година, а болесника са инфарктом без дијабетеса 54, 5±9,6 година (t=1,62; p>0,05). Међу болесницима са дијабетесом било је 14 (27,5%) жена и 37 (72,5%) мушкараца, а код недијабетичара 15 (17,9%) жена и 69 (82,1%) мушкараца (χ 2 =1,66; p>0,05). У периоду праћења умрло је 15 (29,4%) болесника са дијабетесом и 7 (8,3%) без дијабетеса. Морталитет болесника са дијабетесом и инфарктом миокарда био је значајно већи од морталитета болесника са инфарктом без дијабетеса (χ 2 =11,2; p<0,01). Просечни годишњи морталитет болесника са дијабетесом био је 4,2%, а болесника без дијабетеса 1,2% годишње или 3,5 пута мањи. Морталитет жена са дијабетесом био је 2 (14,3%), а мушкараца са дијабетесом 13 (35,1%) (χ 2 =3,15; p>0,05). Од 27 болесника лечених инсулином умрло је 5 (18,5%), а од 24 болесника на оралној терапији -10 (41,7%). Није било значајне разлике у морталитету болесника са дијабетесом лечених инсулином или оралним антидијабетицима (χ 2 =3,61; p>0,05). Закључак. Болесници са дијабетесом имају значајно већи морталитет после инфаркта миокарда од болесника са инфарктом без дијабетеса, што указује да је дијабетес мелитус значајан и независан предиктор, односно предсказивач повећаног морталитета ових болесника. Лечење инсулином повољно утиче на дугорочно преживљавање болесника са дијабетесом после инфаркта миокарда. Кључне речи:дијабетес мелитус, инфаркт миокарда, морталитет.

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Impact of Diabetes on Mortality in Patients With Myocardial Infarction and Left Ventricular Dysfunction

Cited by 140 publications

References 44 publications

Benefit of Revascularization in Non-Infarct-Related Artery in Multivessel Disease Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Benefit of Revascularization in Non-Infarct-Related Artery in Multivessel Disease Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Type of preadmission glucose-lowering treatment and prognosis among patients hospitalised with myocardial infarction: a nationwide follow-up study

Long-term mortality in patients with diabetes mellitus type 2 after acute myocardial infarction

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