Copyright © 1999 by the European Society of Cardiology.
Accelerating impact of diabetes mellitus on mortality in the years following an acute myocardial infarction
a Department of Cardiology, Glostrup University Hospital
b Department of Cardiology, Gentofte University Hospital
Department of Cardiology and Endocrinology, Frederiksberg University Hospital, Hellerup, Denmark
revised January 8, 1999; accepted January 15, 1999
Abstract
Aims The development of risk associated with diabetes mellitus during long-term follow-up after a myocardial infarction has not been studied in detail. We have studied time-related changes of risk of death during 10 years of follow-up in a cohort of patients not treated with thrombolytic therapy (the Glostrup cohort) and during 6 years in a cohort receiving such treatment in 40% of cases (the TRACE cohort).
Methods A subgroup analysis of two cohorts: the Glostrup cohort, which consisted of consecutive cases of acute myocardial infarction who were admitted to one hospital between 1979 and 1983; the TRACE cohort which was comprised of patients with an acute myocardial infarction screened for entry into the Trandolapril Cardiac Evaluation study between May 1990 and June 1992. The Glostrup cohort consisted of 1954 patients and follow-up was for 10 years, The TRACE cohort consisted of 6676 patients and follow-up was for 6 years. Outcome measure was total death.
Results A diagnosis of diabetes mellitus was present in 12% of the two study populations. In multivariate analysis, diabetes mellitus had an independent adverse effect on mortality which increased with time. In the Glostrup cohort risk ratio between day 0 and day 30 was 1·17 and increased to 2·51 (P=0·0002) 7–9 years after discharge from hospital. A similar increase in the risk ratio of diabetes mellitus on mortality was observed in the TRACE cohort (risk ratio for days 0–30 was 1·03, and for years 4–6 was 1·74 (P=0·0001).
Conclusion Diabetes mellitus has no independent influence on mortality immediately following an acute myocardial infarction, but has an important influence on long-term mortality which increases with time. The implication is that the effect of intervention against diabetes in patients with acute myocardial infarction and diabetes mellitus must be evaluated over a long course of time.
Key Words: Diabetes mellitus, acute myocardial infarction, prognosis
f1 Correspondence: Thomas Melchior, MD, PhD, Senior Resident, Department of Medicine B, The Heart Center, The National University Hospital, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. P. Chandler, E. E. Morgan, T. A. McElfresh, T. A. Kung, J. H. Rennison, B. D. Hoit, and M. E. Young Heart failure progression is accelerated following myocardial infarction in type 2 diabetic rats Am J Physiol Heart Circ Physiol, September 1, 2007; 293(3): H1609 - H1616. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. E. Williams, M. I. Chimowitz, G. A. Cotsonis, M. J. Lynn, S. P. Waddy, and for the WASID Investigators Gender Differences in Outcomes Among Patients With Symptomatic Intracranial Arterial Stenosis Stroke, July 1, 2007; 38(7): 2055 - 2062. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.G. Lindholm, S. Boesgaard, C. Torp-Pedersen, L. Kober, and on behalf of the TRACE registry study group Diabetes mellitus and cardiogenic shock in acute myocardial infarction Eur J Heart Fail, August 1, 2005; 7(5): 834 - 839. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Bernard, A. Serusclat, F. Targe, S. Charriere, O. Roth, J. Beaune, F. Berthezene, and P. Moulin Incremental Predictive Value of Carotid Ultrasonography in the Assessment of Coronary Risk in a Cohort of Asymptomatic Type 2 Diabetic Subjects Diabetes Care, May 1, 2005; 28(5): 1158 - 1162. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Cusick, A. D. Meleth, E. Agron, M. R. Fisher, G. F. Reed, G. L. Knatterud, F. B. Barton, M. D. Davis, F. L. Ferris III, E. Y. Chew, et al. Associations of Mortality and Diabetes Complications in Patients With Type 1 and Type 2 Diabetes: Early Treatment Diabetic Retinopathy Study report no. 27 Diabetes Care, March 1, 2005; 28(3): 617 - 625. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Carrabba, R. Valenti, G. Parodi, G. M. Santoro, and D. Antoniucci Left Ventricular Remodeling and Heart Failure in Diabetic Patients Treated With Primary Angioplasty for Acute Myocardial Infarction Circulation, October 5, 2004; 110(14): 1974 - 1979. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Torp-Pedersen, C. Rask-Madsen, I. Gustafsson, F. Gustafsson, and L. Kober Diabetes mellitus and cardiovascular risk: just another risk factor? Eur. Heart J. Suppl., August 1, 2003; 5(suppl_F): F26 - F32. [Abstract] [PDF]
|
|
|
|
|
|
S. D. Solomon, M. S. J. Sutton, G. A. Lamas, T. Plappert, J. L. Rouleau, H. Skali, L. Moye, E. Braunwald, M. A. Pfeffer, and for the Survival And Ventricular Enlargement (SAVE Ventricular Remodeling Does Not Accompany the Development of Heart Failure in Diabetic Patients After Myocardial Infarction Circulation, September 3, 2002; 106(10): 1251 - 1255. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Kanaya, D. Grady, and E. Barrett-Connor Explaining the Sex Difference in Coronary Heart Disease Mortality Among Patients With Type 2 Diabetes Mellitus: A Meta-analysis Arch Intern Med, August 12, 2002; 162(15): 1737 - 1745. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Melchior, C. Rask-Madsen, C. Torp-Pedersen, P. Hildebrandt, L. Kober, and G. Jensen The impact of heart failure on prognosis of diabetic and non-diabetic patients with myocardial infarction: a 15-year follow-up study Eur J Heart Fail, January 1, 2001; 3(1): 83 - 90. [Abstract] [Full Text] [PDF]
|
|