Impaired Glucose Tolerance or Newly Diagnosed Diabetes Mellitus Diagnosed during Admission Adversely Affects Prognosis after Myocardial Infarction : An Observational Study
OBJECTIVE: To investigate the prognostic effect of newly diagnosed diabetes mellitus (NDM) and impaired glucose tolerance (IGT) post myocardial infarction (MI).
RESEARCH DESIGN AND METHODS: Retrospective cohort study of 768 patients without preexisting diabetes mellitus post-MI at one centre in Yorkshire between November 2005 and October 2008. Patients were categorised as normal glucose tolerance (NGT n = 337), IGT (n = 279) and NDM (n = 152) on pre- discharge oral glucose tolerance test (OGTT). Primary end-point was the first occurrence of major adverse cardiovascular events (MACE) including cardiovascular death, non-fatal MI, severe heart failure (HF) or non-haemorrhagic stroke. Secondary end-points were all cause mortality and individual components of MACE.
RESULTS: Prevalence of NGT, impaired fasting glucose (IFG), IGT and NDM changed from 90%, 6%, 0% and 4% on fasting plasma glucose (FPG) to 43%, 1%, 36% and 20% respectively after OGTT. 102 deaths from all causes (79 as first events of which 46 were cardiovascular), 95 non fatal MI, 18 HF and 9 non haemorrhagic strokes occurred during 47.2 ± 9.4 months follow up. Event free survival was lower in IGT and NDM groups. IGT (HR 1.54, 95% CI: 1.06-2.24, p = 0.024) and NDM (HR 2.15, 95% CI: 1.42-3.24, p = 0.003) independently predicted MACE free survival. IGT and NDM also independently predicted incidence of MACE. NDM but not IGT increased the risk of secondary end-points.
CONCLUSION: Presence of IGT and NDM in patients presenting post-MI, identified using OGTT, is associated with increased incidence of MACE and is associated with adverse outcomes despite adequate secondary prevention.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
PloS one - 10(2015), 11 vom: 07., Seite e0142045 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
George, Anish [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 23.06.2016 Date Revised 13.11.2018 published: Electronic-eCollection Citation Status MEDLINE |
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| doi: |
10.1371/journal.pone.0142045 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM254651097 |
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| 245 | 1 | 0 | |a Impaired Glucose Tolerance or Newly Diagnosed Diabetes Mellitus Diagnosed during Admission Adversely Affects Prognosis after Myocardial Infarction |b An Observational Study |
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| 500 | |a Date Revised 13.11.2018 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To investigate the prognostic effect of newly diagnosed diabetes mellitus (NDM) and impaired glucose tolerance (IGT) post myocardial infarction (MI) | ||
| 520 | |a RESEARCH DESIGN AND METHODS: Retrospective cohort study of 768 patients without preexisting diabetes mellitus post-MI at one centre in Yorkshire between November 2005 and October 2008. Patients were categorised as normal glucose tolerance (NGT n = 337), IGT (n = 279) and NDM (n = 152) on pre- discharge oral glucose tolerance test (OGTT). Primary end-point was the first occurrence of major adverse cardiovascular events (MACE) including cardiovascular death, non-fatal MI, severe heart failure (HF) or non-haemorrhagic stroke. Secondary end-points were all cause mortality and individual components of MACE | ||
| 520 | |a RESULTS: Prevalence of NGT, impaired fasting glucose (IFG), IGT and NDM changed from 90%, 6%, 0% and 4% on fasting plasma glucose (FPG) to 43%, 1%, 36% and 20% respectively after OGTT. 102 deaths from all causes (79 as first events of which 46 were cardiovascular), 95 non fatal MI, 18 HF and 9 non haemorrhagic strokes occurred during 47.2 ± 9.4 months follow up. Event free survival was lower in IGT and NDM groups. IGT (HR 1.54, 95% CI: 1.06-2.24, p = 0.024) and NDM (HR 2.15, 95% CI: 1.42-3.24, p = 0.003) independently predicted MACE free survival. IGT and NDM also independently predicted incidence of MACE. NDM but not IGT increased the risk of secondary end-points | ||
| 520 | |a CONCLUSION: Presence of IGT and NDM in patients presenting post-MI, identified using OGTT, is associated with increased incidence of MACE and is associated with adverse outcomes despite adequate secondary prevention | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 7 | |a Blood Glucose |2 NLM | |
| 700 | 1 | |a Bhatia, Raghav T |e verfasserin |4 aut | |
| 700 | 1 | |a Buchanan, Gill L |e verfasserin |4 aut | |
| 700 | 1 | |a Whiteside, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Moisey, Robert S |e verfasserin |4 aut | |
| 700 | 1 | |a Beer, Stephen F |e verfasserin |4 aut | |
| 700 | 1 | |a Chattopadhyay, Sudipta |e verfasserin |4 aut | |
| 700 | 1 | |a Sathyapalan, Thozhukat |e verfasserin |4 aut | |
| 700 | 1 | |a John, Joseph |e verfasserin |4 aut | |
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