Long-term prognostic importance of diabetes after a myocardial infarction depends on left ventricular systolic function

TY - JOUR

T1 - Long-term prognostic importance of diabetes after a myocardial infarction depends on left ventricular systolic function

AU - Andersson, Charlotte

AU - Gislason, Gunnar H

AU - Mérie, Charlotte

AU - Mogensen, Ulrik M

AU - Solomon, Scott D

AU - Torp-Pedersen, Christian

AU - Køber, Lars

PY - 2011/8

Y1 - 2011/8

N2 - OBJECTIVE - This study was performed to understand how left ventricular function modulates the prognostic importance of diabetes after myocardial infarction (MI). RESEARCH DESIGN AND METHODS - Consecutively hospitalized MI patients screened for three clinical trials were followed for a median of 7 years. Multivariable Cox regression models were used to assess the risk of mortality associated with diabetes, and the importance of diabetes was examined independently within defined left ventricular ejection fraction (LVEF) subgroups. RESULTS - A total of 16,912 patients were included; 1,819 (11%) had diabetes. Diabetes and 15% unit depression in LVEF were of similar prognostic importance: hazard ratios (HRs) were 1.45 (95% CI 1.37-1.54) and 1.41 (1.37-1.45) for diabetes and LVEF depression, respectively. LVEF modified the outcomes associated with diabetes, with HRs being 1.29 (1.19-1.40) and 1.61 (1.49-1.74) in patients with LVEF <40% and LVEF ≥40%, respectively (P = 0.03). CONCLUSIONS - Patients within the higher LVEF categories have a greater mortality risk attributable to diabetes than patients within the lower LVEF categories.

AB - OBJECTIVE - This study was performed to understand how left ventricular function modulates the prognostic importance of diabetes after myocardial infarction (MI). RESEARCH DESIGN AND METHODS - Consecutively hospitalized MI patients screened for three clinical trials were followed for a median of 7 years. Multivariable Cox regression models were used to assess the risk of mortality associated with diabetes, and the importance of diabetes was examined independently within defined left ventricular ejection fraction (LVEF) subgroups. RESULTS - A total of 16,912 patients were included; 1,819 (11%) had diabetes. Diabetes and 15% unit depression in LVEF were of similar prognostic importance: hazard ratios (HRs) were 1.45 (95% CI 1.37-1.54) and 1.41 (1.37-1.45) for diabetes and LVEF depression, respectively. LVEF modified the outcomes associated with diabetes, with HRs being 1.29 (1.19-1.40) and 1.61 (1.49-1.74) in patients with LVEF <40% and LVEF ≥40%, respectively (P = 0.03). CONCLUSIONS - Patients within the higher LVEF categories have a greater mortality risk attributable to diabetes than patients within the lower LVEF categories.

U2 - 10.2337/dc11-0154

DO - 10.2337/dc11-0154

M3 - Journal article

C2 - 21715523

SN - 0149-5992

VL - 34

SP - 1788

EP - 1790

JO - Diabetes Care

JF - Diabetes Care

IS - 8

ER -