The Impact of Type 2 Diabetes Mellitus on Long-Term Prognosis in Patients of Different Ages with Myocardial Infarction

Afanasiev, S. A.; Гарганеева, А. А.; Кужелева, Е. А.; Andriyanova, A. V.; Кондратьева, Д. С.; Попов, С. В.

doi:10.1155/2018/1780683

Cited by 19 publications

(15 citation statements)

References 19 publications

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“…The VALIANT trial showed that both previously known diabetes and incident diabetes increased the risk of new cardiovascular events and death after an acute myocardial infarction [21]. Other authors have reported an even higher impact on behalf of T2DM on the prognoses of the elderly patients after a myocardial infarction than in younger patients [22]. Moreover, the increased mortality risk conferred by T2DM has also been described for stroke [23].…”

Section: Discussionmentioning

confidence: 98%

All-Cause Mortality And Cardiovascular Events In A Spanish Nonagenarian Cohort According To Type 2 Diabetes Mellitus Status And Established Cardiovascular Disease

Salinero-Fort

Mostaza-Prieto

Lahoz-Rallo

et al. 2021

Preprint

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Background: To analyze all-cause mortality and cardiovascular events in nonagenarians from a Mediterranean population.Methods: Primary Health Care (265 health centres)Participants: Primary health records of all the nonagenarians living in the Community of Madrid (N=59,423). We defined 4 groups according to prevalent type 2 diabetes mellitus and established cardiovascular disease: (1) type 2 diabetes mellitus (-), cardiovascular disease (-); (2) type 2 diabetes mellitus (-), cardiovascular disease (+); (3) type 2 diabetes mellitus (+), cardiovascular disease (-); and (4) type 2 diabetes mellitus (+), cardiovascular disease (+). Follow-up time was 2.5 years. Primary outcome: Cumulative incidence and the density incidence rates of all-cause mortality, non-fatal myocardial infarction, non-fatal stroke (combined they constituted the first composite primary outcome (CPO1)), and heart failure (similarly, combined with the previous they constituted CPO2). We evaluated the adjusted effect of groups classification on all-cause mortality (Cox regression). Results. Mean age was 93.3±2.8 years; 74.2% were women. Hypertension, dyslipidemia, heart failure, albuminuria and estimated glomerular filtration rate <60 mL/min/1.73m2 were significantly more prevalent in group 4 (type 2 diabetes mellitus (+), cardiovascular disease (+)) than in the other groups (all p values <0.001). We observed significantly higher rates of cumulative incidence of all-cause mortality, CPO1 and CPO2 in participants belonging to group 4 (all p values ≤0.001). People in group 2 (type 2 diabetes mellitus (-), cardiovascular disease (+)) presented higher rates of all-cause mortality, heart failure, CPO1 and CPO2 than people in group 3 (type 2 diabetes mellitus (+), cardiovascular disease (-)) (all p values ≤0.001). In the fully-adjusted model, prevalent type 2 diabetes mellitus plus established cardiovascular disease (group 4) independently predicted all-cause mortality (HR=1.48 (95% CI, 1.40 to 1.57) as compared to reference group 1 (type 2 diabetes mellitus (-), cardiovascular disease (-)) (p <0.01). Also, cardiovascular disease and type 2 diabetes mellitus alone showed significant HRs (1.13 and 1.14, respectively; both p values <0.01)).Conclusions. In Spanish nonagenarians, established cardiovascular disease and type 2 diabetes mellitus conferred modest all-cause mortality risks. The concurrent presence of both conditions conferred the highest all-cause mortality risk.

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Section: Discussionmentioning

confidence: 98%

All-Cause Mortality And Cardiovascular Events In A Spanish Nonagenarian Cohort According To Type 2 Diabetes Mellitus Status And Established Cardiovascular Disease

Salinero-Fort

Mostaza-Prieto

Lahoz-Rallo

et al. 2021

Preprint

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show abstract

Section: Discussionmentioning

confidence: 99%

All-cause mortality and cardiovascular events in a Spanish nonagenarian cohort according to type 2 diabetes mellitus status and established cardiovascular disease

et al. 2022

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Background Despite the progressive aging of the population in industrialized countries, few studies have focused on the natural history of cardiovascular disease in the very old, and recommendations on prevention of cardiovascular disease in this population are lacking. We aimed to analyze all-cause mortality and cardiovascular events according to prevalent type 2 diabetes mellitus and established cardiovascular disease in nonagenarians from a Mediterranean population. Methods We analyzed the primary health records of all nonagenarians living in the Community of Madrid (N = 59,423) and collected data for 4 groups: Group 1, individuals without T2DM or established CVD (T2DM-, CVD-); Group 2, individuals without T2DM but with established CVD (T2DM-, CVD +); Group 3, individuals with T2DM but without established CVD (T2DM + , CVD-); and Group 4, individuals with both T2DM and established CVD (T2DM + , CVD +), taking into account the influence of sex on the outcomes. Follow-up was 2.5 years. The primary outcomes were cumulative incidence and incidence density rates for all-cause mortality, non-fatal myocardial infarction, non-fatal stroke (the first composite primary outcome [CPO1]), combined with heart failure (CPO2). We evaluated the adjusted effect of each group on all-cause mortality (Cox regression). Results Mean age was 93.3 ± 2.8 years (74.2% women). Hypertension, dyslipidemia, heart failure, albuminuria, and estimated glomerular filtration rate < 60 mL/min/1.73 m2 were significantly more prevalent in G4 than in the other groups (all p values < 0.001). We observed significantly higher cumulative incidence rates for all-cause mortality, CPO1, and CPO2 in participants belonging to G4 (all p values ≤ 0.001). People in G2 presented higher rates of all-cause mortality, heart failure, CPO1, and CPO2 than people in G3 (all p values ≤ 0.001). In the fully adjusted model, G4 independently predicted all-cause mortality (HR = 1.48 [95% CI, 1.40 to 1.57] vs reference G1 [p < 0.01]). In addition, significant HRs were recorded for cardiovascular disease alone (G2) and type 2 diabetes mellitus alone (G3) (1.13 and 1.14, respectively; both p values < 0.01). Conclusions In Spanish nonagenarians, established cardiovascular disease and type 2 diabetes mellitus conferred a modest risk of all-cause mortality. However, the simultaneous presence of both conditions conferred the highest risk of all-cause mortality.

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“…It is worth noting that type 2 DM increases 5-year mortality in elderly patients with AMI. While younger patients with AMI and type 2 DM are more likely to have complications in the early period after AMI compared to patients of the same age group but without type 2 DM [6]. The adverse effect of DM on in-hospital mortality rates after AMI was further confirmed by a recent cohort study including more than 5,000 STEMI patients following primary PCI [7].…”

Section: Introductionmentioning

confidence: 90%

Characteristics of the acute myocardial infarction course in patients with type 2 diabetes mellitus before and after reperfusion therapy

Koteliukh¹,

Kravchun²,

Dobrovolska³

2022

Науковий вісник Ужгородського університету. Серія Медицина

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Characteristics of the acute myocardial infarction course in patients with type 2 diabetes mellitus before and after reperfusion therapyIntroduction. Scientific research is currently being done to diagnose and manage comorbid conditions in patients. The importance of studying the pathophysiological mechanisms of acute myocardial infarction (AMI) in patients with type 2 diabetes mellitus (DM) has been proven.The purpose of the study: to conduct a retrospective analysis before and after reperfusion therapy by evaluating the features of the AMI course in patients with type 2 DM.Material and methods. The study was conducted from January 10, 2020 to January 12, 2021. In total, 74 STEMI patients with or without type 2 DM, aged 59.42±7.66 years were examined at the Intensive Care Unit of the Government Institution "L. T. Malaya National Therapy Institute of the National Academy of Medical Sciences of Ukraine" and the Kharkiv Railway Clinical Hospital No. 1 of the branch "Center of Healthcare" of Public Joint Stock Company "Ukrainian Railway". Serum levels of insulin, adropin, irisin, fatty acid binding protein 4 (FABP4) and C1q/TNF-related protein (CTRP3) were detected by enzyme-linked immunosorbent assay. Analysis and processing of the findings obtained after examinations were carried out using the computer program IBM SPPS software, version 27.0 (IBM Inc., USA, 2020).Results and discussion. Before the treatment, patients with AMI and type 2 DM had significantly higher values of end-systolic size (ESS) by 5.56%, left atrium (LA) by 10.53%, left ventricular myocardial mass index (LVMMI) by 6.87% and lower values of systolic blood pressure (SBP) by 11.76%, atherogenic index (AI) by 5.80%, glucose by 25.71%, insulin by 39.92%, irisin by 15.34%, FABP4 by 19.76% compared to the values of these indicators 14 days after medicamentous therapy (p<0.05). Patients with AMI and type 2 DM had significantly higher values of adropin by 46.10%, irisin by 20.11%, CTRP3 by 28.78% and lower values of SBP by 17.65%, diastolic blood pressure by 12.38%, heart rate (HR) by 13.73%, pulse by 10.87%, body mass index by 5.57%, weight by 9.52%, glucose by 26.67%, insulin by 40, 75%, total cholesterol by 10.04%, very low-density lipoproteins by 24.75%, low-density lipoproteins by 8.52%, triglycerides by 27.06%, AI by 10.55%, FABP4 by 37.04% before treatment as compared to the values of these indicators 14 days after percutaneous coronary intervention (PCI) (p<0.05). Comparing the studied indicators between subgroups after medicamentous treatment and PCI, a significant decrease in HR by 8.33%, ESS by 4.11%, LA by 9.52%, LVMMI by 5.53%, FABP4 by 21.53% and an increase in the levels of adropin by 36.99%, irisin by 41.88%, CTRP3 by 30.25%, high-density lipoproteins (HDL) by 10.28% were identified (p<0.05).Conclusions. When compared PCI advantages due to the absence of a tendency to the left heart dilatation over the medicamentous therapy, improvements of energy and adipokine metabolism have been observed amid increased levels of adropin, irisin and CT...

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The Impact of Type 2 Diabetes Mellitus on Long-Term Prognosis in Patients of Different Ages with Myocardial Infarction

Cited by 19 publications

References 19 publications

All-Cause Mortality And Cardiovascular Events In A Spanish Nonagenarian Cohort According To Type 2 Diabetes Mellitus Status And Established Cardiovascular Disease

All-Cause Mortality And Cardiovascular Events In A Spanish Nonagenarian Cohort According To Type 2 Diabetes Mellitus Status And Established Cardiovascular Disease

All-cause mortality and cardiovascular events in a Spanish nonagenarian cohort according to type 2 diabetes mellitus status and established cardiovascular disease

Characteristics of the acute myocardial infarction course in patients with type 2 diabetes mellitus before and after reperfusion therapy

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