Copyright © 2004 by the European Society of Cardiology.
Clinical research
Long-term, cause-specific mortality after myocardial infarction in diabetes
a Department of Cardiology, Isala Klinieken, locatie Weezenlanden, Groot Wezenland 20, 8011 Zwolle JW, The Netherlands
b Department of Cardiology, Thoraxcenter, University Hospital Groningen, Groningen, The Netherlands
* Corresponding author. Tel.: +31-384242374; fax: +31-384243222
E-mail address: v.r.c.derks{at}isala.nl
Received 11 November 2003; revised 30 March 2004; accepted 2 April 2004
Abstract
Aims To compare long-term, cause-specific mortality after reperfusion therapy for ST segment elevation myocardial infarction (STEMI) in patients with and without diabetes.
Methods and results Patients with STEMI (
) were randomised to intravenous streptokinase (SK) or primary percutaneous coronary intervention (PCI). Median follow-up was 7.5 years (interquartile range 5.6–8.5). A total of 74 patients (19%) had diabetes. Reduced left ventricular ejection fraction (<40%) after STEMI was more often observed in patients with diabetes (27% vs. 15%, 
). Patients with diabetes had a higher total mortality compared to patients without diabetes (HR 2.4; 
). Multivariate analysis confirmed that diabetes was an independent risk factor for long-term mortality (HR 2.3; ). The incidence of sudden death was comparable in both patient groups (HR 1.6; 
). The increased mortality in patients with diabetes was mainly caused by heart failure (HR 3.1; 
). In patients with diabetes, primary PCI was associated with an improved prognosis.
Conclusions Despite reperfusion therapy, STEMI patients with diabetes have an increased long-term mortality. This is due to death by heart failure and not by an increase in sudden death. Primary PCI is associated with an improved prognosis, particularly in patients with diabetes.
Key Words: Diabetes • Myocardial infarction • Angioplasty • Clinical outcome
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. E. Hofsten, B. B. Logstrup, J. E. Moller, P. A. Pellikka, and K. Egstrup Abnormal glucose metabolism in acute myocardial infarction influence on left ventricular function and prognosis. J. Am. Coll. Cardiol. Img., May 1, 2009; 2(5): 592 - 599. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Ishihara, I. Inoue, T. Kawagoe, Y. Shimatani, S. Kurisu, T. Hata, Y. Nakama, Y. Kijima, and E. Kagawa Is admission hyperglycaemia in non-diabetic patients with acute myocardial infarction a surrogate for previously undiagnosed abnormal glucose tolerance? Eur. Heart J., October 2, 2006; 27(20): 2413 - 2419. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R J van der Schaaf, J P S Henriques, J J Wiersma, K T Koch, J Baan Jr, K J J Mulder, J D Durrer, J G P Tijssen, J J Piek, and R J de Winter Primary percutaneous coronary intervention for patients with acute ST elevation myocardial infarction with and without diabetes mellitus Heart, January 1, 2006; 92(1): 117 - 118. [Full Text] [PDF]
|
|
|
|
|
|
J. P. van Melle, P. de Jonge, J. Ormel, H. J.G.M. Crijns, D. J. van Veldhuisen, A. Honig, A. H. Schene, M. P. van den Berg, and for the MIND-IT investigators Relationship between left ventricular dysfunction and depression following myocardial infarction: data from the MIND-IT Eur. Heart J., December 2, 2005; 26(24): 2650 - 2656. [Abstract] [Full Text] [PDF]
|
|