Differential Prognostic Impacts of Diabetes over Time Course after Acute Myocardial Infarction

Title
Differential Prognostic Impacts of Diabetes over Time Course after Acute Myocardial Infarction
Author(s)
김영조최동주[최동주]강시혁[강시혁]윤창환[윤창환]조구영[조구영]최인호[최인호]최성철[최성철]김주한[김주한]안영균[안영균]정명호[정명호]Hack-Lyoung Kim,[Hack-Lyoung Kim,]
Keywords
ACUTE CORONARY SYNDROMES; HEART-DISEASE; CLINICAL-OUTCOMES; 30-DAY SURVIVORS; GLOBAL REGISTRY; RISK SCORE; MORTALITY; MELLITUS; EVENTS; TERM
Issue Date
201312
Publisher
KOREAN ACAD MEDICAL SCIENCES
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.28, no.12, pp.1749 - 1755
Abstract
This study was performed to evaluate the effects of diabetes on short-and mid-term clinical outcomes in patients with acute myocardial infarction (AMI). Between October 2005 and December 2009, a total of 22,347 patients with AMI from a nationwide registry was analyzed. At the time point of the day 30 after AMI onset, landmark analyses were performed for the development of major adverse cardiovascular events (MACEs), including death, re-infarction and revascularization. In this cohort, 6,131 patients (27.4%) had diabetes. Short-term MACEs, which occurred within 30 days of AMI onset, were observed in 1,364 patients (6.1%). Among the 30-day survivors (n=21,604), mid-term MACEs, which occurred between 31 and 365 days after AMI onset, were observed in 1,181 patients (5.4%). After adjustment for potential confounders, diabetes was an independent predictor of mid-term MACEs (HR, 1.25; 95% CI, 1.08-1.45; P=0.002), but not of short-term MACEs (HR: 1.16; 95% CI: 0.93-1.44; P=0.167). Diabetes is a poor prognostic factor for mid-term clinical outcomes but not for short-term outcomes in AMI patients. Careful monitoring and intensive care should be considered in diabetic patients, especially following the acute stage of AMI.
URI
http://hdl.handle.net/YU.REPOSITORY/28148http://dx.doi.org/10.3346/jkms.2013.28.12.1749
ISSN
1011-8934
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의과대학 > 내과학교실 > Articles
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