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Diab Vasc Dis Res. 2015 Jan;12(1):23-32. doi: 10.1177/1479164114551746. Epub 2014 Oct 13.

Sustained prognostic implications of newly detected glucose abnormalities in patients with acute myocardial infarction: long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort.

Author information

1
Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden Unit for Research and Development Kronoberg County Council, Växjö, Sweden viveca.ritsinger@ki.se.
2
Department of Medicine and Centre for Clinical Research, Central Hospital Västerås, Västerås, Sweden.
3
Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
4
Centre for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden.

Abstract

OBJECTIVE:

To investigate long-term prognostic importance of newly discovered glucose disturbances in patients with acute myocardial infarction (AMI).

METHODS:

During 1998-2001, consecutive patients with AMI (n = 167) and healthy controls (n = 184) with no previously known diabetes were investigated with an oral glucose tolerance test (OGTT). Patients and controls were separately followed up for cardiovascular events (first of cardiovascular mortality/AMI/stroke/heart failure) during a decade.

RESULTS:

In all, 68% of the patients and 35% of the controls had newly detected abnormal glucose tolerance (AGT). Cardiovascular event (n = 72, p = 0.0019) and cardiovascular mortality (n = 31, p = 0.031) were more frequent in patients with newly detected AGT. Regarding patients, a Cox proportional-hazard regression analysis identified AGT (hazard ratio (HR): 2.30; 95% confidence interval (CI): 1.24-4.25; p = 0.008) and previous AMI (HR: 2.39; CI: 1.31-4.35; p = 0.004) as prognostically important.

CONCLUSION:

An OGTT at discharge after AMI disclosed a high proportion of patients with previously unknown AGT which had a significant and independent association with long-term prognosis.

KEYWORDS:

Myocardial infarction; diabetes; impaired glucose tolerance; oral glucose tolerance test; prognosis

PMID:
25311248
DOI:
10.1177/1479164114551746
[Indexed for MEDLINE]

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