PROGNOSIS OF ACUTE MYOCARDIAL-INFARCTION IN DIABETIC AND NONDIABETIC PATIENTS

被引:63
作者
KARLSON, BW [1 ]
HERLITZ, J [1 ]
HJALMARSON, A [1 ]
机构
[1] SAHLGRENS UNIV HOSP,DIV CARDIOL,S-41345 GOTHENBURG,SWEDEN
关键词
ACUTE MYOCARDIAL INFARCTION; DIABETES-MELLITUS; PROGNOSIS;
D O I
10.1111/j.1464-5491.1993.tb00097.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We evaluated the prognosis of 858 patients with acute myocardial infarction (MI), of whom 97 (11%) had a history of diabetes mellitus. Among patients with diabetes the 1-year mortality rate was 41% versus 26% for non-diabetic patients (p < 0.01), and the 1-year reinfarction rates were 23% and 14%, respectively (p = 0.05). Diabetic patients with a history of hypertension had a similar mortality rate as comapred with diabetic patients without hypertension. In a multivariate analysis including age and history of cardiovascular disease, diabetes did not significantly contribute to death or reinfarction. Among diabetic patients the only independent risk factor for death was age. The place and mode of death appeared similar in the two groups. Patients with and without a history of diabetes had a similar infarct size. We conclude that diabetic patients with acute myocardial infarction have a very poor prognosis. Within 1 year nearly half of them are dead and one-quarter develop reinfarction. The mode of death appeared to be similar in diabetic patients as compared with non-diabetic patients.
引用
收藏
页码:449 / 454
页数:6
相关论文
共 29 条
[1]  
Schlant RC, Forman S., Stamler J., Canner PL., The natural history of coronary heart disease: prognostic factors after recovery from myocardial infarction in 2789 men: the 5‐year findings of the Coronary Drug Project, Circulation, 66, pp. 401-414, (1982)
[2]  
Henning R., Swedish cooperative CCU Study. Part II. The short‐term prognosis, Acta Med Scand, pp. 1-35, (1975)
[3]  
Rytter L., Troelsen S., Beck-Nielsen H., Prevalence and mortality of acute myocardial infarction in patients with diabetes, Diabetes Care, 8, pp. 230-234, (1985)
[4]  
Malmberg K., Ryden L., Myocardial infarction in patients with diabetes mellitus, Eur Heart J, 9, pp. 259-264, (1988)
[5]  
Recommended methods for the determination of four enzymes in blood, Scand J Clin Lab Invest, 33, pp. 291-306, (1974)
[6]  
Recommended method for the determination of creatinine kinase in blood modified by the inclusion of EDTA, Scand J Clin Lab Invest, 39, pp. 1-5, (1979)
[7]  
Olsson L-O, Larsson B., Eriksson H., Svardsudd K., Welin L., Tibblin G., Diabetes mellitus in Swedish middle aged men. Analysis of the study of men born 1913 and 1923, Diabetologia, 30, pp. 386-393, (1987)
[8]  
Chipkin SR, Frid D., Alpert JS, Baker SP, Dalen JE, Aronin N., Frequency of painless myocardial ischemia during exercise tolerance testing in patients with and without diabetes mellitus, Am J Cardiol, 59, pp. 61-65, (1987)
[9]  
Niakan E., Harati Y., Rolak LA, Comstock JP, Rokey R., Silent myocardial infarction and diabetic cardiovascular autonomic neuropathy, Arch Intern Med, 146, pp. 2229-2230, (1986)
[10]  
Kuusisto AN, Syndanmaa JE., Observations on myocardial infarction and diabetes, Ann Med Intern Fenn, 49, pp. 235-246, (1960)