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July 1, 2010Clinical CardiologyOpen Access

Baseline diabetes mellitus was associated with increased long-term all-cause mortality (HR 1.31, P=0.038) and cardiovascular mortality (HR 1.69, P=0.001) in patients following acute MI.

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Why the study?

Does diabetes mellitus at baseline increase long-term mortality in patients hospitalized with acute myocardial infarction?

Population

337 patients hospitalized with acute myocardial infarction (MI), mean age 66.4 years, 61.1% men.

Comparison

Presence of diabetes mellitus (DM) at baseline vs Absence of diabetes mellitus at baseline

Design

Cohort

Follow-up

median 16.6 years

Key result

Baseline diabetes mellitus was associated with increased long-term all-cause mortality (HR 1.31, P=0.038) and cardiovascular mortality (HR 1.69, P=0.001) in patients following acute MI.

Authors

MGMark GruppettaNCNeville CallejaSFStephen Fava

Discussion

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Overview

Diabetes at acute MI presentation was associated with higher long-term mortality; leaves open whether it merits MI-equivalent status in contemporary cohorts.

Key Points

  • This research aimed to evaluate the impact of type 2 diabetes and other risk factors on long-term survival after acute myocardial infarction.
  • Followed 337 patients hospitalized with myocardial infarction from December 1990 to November 1992 until January 31, 2008.
  • Used Kaplan-Meier method for survival curve generation and Cox regression analysis for risk assessments.
  • Recorded baseline data including diabetes status, history of myocardial infarction, and patient age.
  • Long-term survival was associated with a history of myocardial infarction (HR: 1.47, P = 0.016) and baseline diabetes (HR: 1.31, P = 0.038).
  • Cardiovascular mortality was linked to previous myocardial infarction (HR: 1.58, P = 0.017) and baseline diabetes (HR: 1.69, P = 0.001).
  • Diabetes was found to confer a risk level similar to a previous myocardial infarction.

Study Design

Type

Cohort (n=337)

Structured PICO

Does diabetes mellitus at baseline increase long-term mortality in patients hospitalized with acute myocardial infarction?

P
Population
337 patients hospitalized with acute myocardial infarction, followed for a median of 16.6 years.
E
Exposure
Presence of diabetes mellitus (DM) at baseline
C
Comparator
Absence of diabetes mellitus at baseline
O
Outcome
Long-term survival (all-cause mortality) at median 16.6 yearshard clinical

Main Result

Hazard Ratio: 1.31

p-value: p=0.038

In patients with acute myocardial infarction, diabetes mellitus confers a long-term mortality risk equivalent to having had a previous MI, suggesting DM should be considered an MI equivalent.

Cite This Study

Gruppetta et al. (2010) conducted a cohort in Acute Myocardial Infarction (n=337). Diabetes mellitus at baseline vs. No diabetes mellitus was evaluated on Long-term survival (all-cause mortality) (HR 1.31, p=0.038). Baseline diabetes mellitus was associated with increased long-term all-cause mortality (HR 1.31, P=0.038) and cardiovascular mortality (HR 1.69, P=0.001) in patients following acute MI.

synapsesocial.com/papers/6a6b5e776f523709a0249a60https://doi.org/10.1002/clc.20776
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