Trends in Prevalence of Diabetes Mellitus in Patients with Myocardial Infarction and Effect of Diabetes on Survival: The Minnesota Heart Survey

Jm, Sprafka; Gl, Burke; Ar, Folsom; Pg, McGovern; Lp, Hahn

doi:10.2337/diacare.14.7.537

Cited by 161 publications

(80 citation statements)

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“…Mean non-HDL-C levels, already higher among diabetic patients, did not decline as rapidly for this group, increasing the gap between them and patients without diabetes. The evidence that CAD patients with diabetes have a greater risk of cardiovascular events than CAD patients without diabetes is clear and convincing (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Numerous studies have also shown that diabetic patients receive as much if not more benefit from statin treatment than CAD patient without diabetes (11)(12)(13)(14).…”

Section: Lipid Concentration Trendsmentioning

confidence: 99%

“…T he increased risk of cardiovascular events associated with diabetes is well established (1)(2)(3)(4)(5)(6). In a recent report from a Finnish cohort, Haffner et al (2) demonstrate that diabetic patients without a prior myocardial infarction (MI) had approximately the same 7-year incidence of MI (ϳ20%) as nondiabetic patients with a prior MI (2).…”

mentioning

confidence: 99%

“…Thus, a multitude of clinical and epidemiological evidence indicates that individuals with both CAD and diabetes are at an exceptionally high risk for new cardiovascular events and mortality compared with those with either CAD or diabetes alone (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Patients with combined CAD and diabetes represent one of the highest risk populations commonly seen by physicians in the outpatient setting.…”

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confidence: 99%

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Trends in Lipid Management Among Patients With Coronary Artery Disease

et al. 2003

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OBJECTIVE -To examine lipid management trends for coronary artery disease (CAD) patients with and without diabetes in order to determine whether those with diabetes are beginning to receive aggressive lipid management consistent with their elevated risk.RESEARCH DESIGN AND METHODS -We used outpatient medical record data from 47,813 CAD patients seen at 295 medical practices participating in the Quality Assurance Program II between 1996 and 1998. Lipid testing rates, lipid treatment rates, and serum lipid concentrations are described for CAD patients with and without diabetes within strata of office visit date.RESULTS -Lipid testing and treatment rates increased and mean lipid levels decreased markedly over time. Those with diabetes were 26% less likely to have a lipid profile and 17% less likely to receive a lipid-lowering medication than their nondiabetic counterparts, and this disparity did not diminish over time. Among treated patients, mean non-HDL cholesterol (non-HDL-C) and LDL cholesterol (LDL-C) declined less rapidly over time for patients with than without diabetes.CONCLUSIONS -Although impressive progress was made in the outpatient lipid management of CAD patients, lipid management for CAD patients with diabetes improved no more rapidly, and in some cases less rapidly, than for nondiabetic patients. Given their higher risk, more effort is needed to ensure that CAD patients with diabetes receive aggressive lipid management. Diabetes Care 26:991-997, 2003T he increased risk of cardiovascular events associated with diabetes is well established (1-6). In a recent report from a Finnish cohort, Haffner et al. (2) demonstrate that diabetic patients without a prior myocardial infarction (MI) had approximately the same 7-year incidence of MI (ϳ20%) as nondiabetic patients with a prior MI (2). This finding is consistent with a recent report of patients hospitalized with unstable angina or non-Q-wave MI showing that the 2-year event rate for diabetic patients without prior coronary artery disease (CAD) was similar to that of nondiabetic patients with prior CAD (3). Another important finding from both studies, and one especially relevant for this report, is that the incidence of new MI among diabetic patients with a prior MI is more than twice that of patients with either prior MI or diabetes alone. Others have demonstrated that CAD patients with diabetes are more likely to die following an MI than their nondiabetic counterparts (4 -6).Thus, a multitude of clinical and epidemiological evidence indicates that individuals with both CAD and diabetes are at an exceptionally high risk for new cardiovascular events and mortality compared with those with either CAD or diabetes alone (1-10). Patients with combined CAD and diabetes represent one of the highest risk populations commonly seen by physicians in the outpatient setting.Although at high risk for future cardiovascular events, individuals with CAD and diabetes are as likely as those without diabetes to benefit from 3-hydroxy-3-methylglutaryl coenzyme A reductase in...

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Section: Lipid Concentration Trendsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Trends in Lipid Management Among Patients With Coronary Artery Disease

et al. 2003

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“…A number of studies have found relationships between the macrovascular (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and microvascular complications of diabetes and mortality. However, many of these studies assessed complications individually, failing to consider other putative risk factors and complications.…”

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confidence: 99%

Associations of Mortality and Diabetes Complications in Patients With Type 1 and Type 2 Diabetes

et al. 2005

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OBJECTIVE—Diabetes is a leading cause of morbidity and mortality. The purpose of this study is to assess the associations between diabetes complications and mortality in the Early Treatment Diabetic Retinopathy Study (ETDRS). RESEARCH DESIGN AND METHODS—We examined demographic, clinical, and laboratory characteristics of the 3,711 subjects enrolled in the ETDRS, a randomized controlled clinical trial designed to evaluate the role of laser photocoagulation and aspirin therapy for diabetic retinopathy. The outcome assessed was all-cause mortality. Multivariable Cox proportional hazards regression was used to assess associations between diabetes complications and mortality for type 1 and type 2 diabetes separately. RESULTS—The 5-year estimates of all-cause mortality were 5.5 and 18.9% for patients with type 1 and type 2 diabetes, respectively. In patients with type 1 diabetes, amputation (hazard ratio [HR] 5.08 [95% CI 2.06–12.54]) and poor visual acuity (1.74 [1.10–2.75]) remained significantly associated with mortality, after adjusting for other diabetes complications and baseline characteristics. In patients with type 2 diabetes, macrovascular disease and worsening levels of nephropathy, neuropathy, retinopathy, and visual acuity are associated with progressively increasing risks of mortality, after controlling for other baseline risk factors. CONCLUSIONS—Amputation is the strongest predictor for mortality in patients with type 1 diabetes. All complications independently predict mortality in patients with type 2 diabetes. There is an increased risk for mortality as the degree of each complication worsens. Additional studies are needed to investigate the effectiveness of tertiary prevention to decrease mortality in these patients.

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“…3,4 Within the first year after MI, 59.3% of dialysis patients will die, and by 5 years, 89% will die. 5 This high mortality rate may be due to underutilization of life-saving medical and revascularization therapies.…”

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confidence: 99%

The use of invasive cardiac procedures after acute myocardial infarction in long-term dialysis patients

Charytan

Mauri

Agarwal

et al. 2006

American Heart Journal

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Background-Dialysis patients have an excessive risk of cardiovascular death after myocardial infarction (MI). Underutilization of cardiac therapies may partially explain this risk, but whether patients on maintenance dialysis have differential rates of coronary angiography or revascularization during admission for MI compared with patients not on dialysis and whether these differences are explained by the presence of comorbid illness were uncertain.

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Trends in Prevalence of Diabetes Mellitus in Patients with Myocardial Infarction and Effect of Diabetes on Survival: The Minnesota Heart Survey

Cited by 161 publications

References 0 publications

Trends in Lipid Management Among Patients With Coronary Artery Disease

Trends in Lipid Management Among Patients With Coronary Artery Disease

Associations of Mortality and Diabetes Complications in Patients With Type 1 and Type 2 Diabetes

The use of invasive cardiac procedures after acute myocardial infarction in long-term dialysis patients

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