Diabetes mellitus unawareness is a strong determinant of mortality in patients manifesting myocardial infarction. (November 2013)

• Record Type: Journal Article
• Authors: Figueiredo, Valéria N.; Godoi, Filipe Canela de Souza; Martins, Nestor S.; Quinaglia e Silva, Jose C.; Nadruz, Wilson; Coelho, Otavio R.; Sposito, Andrei C.
• Is Part Of: Current medical research and opinion. Volume 29:Number 11(2013:Nov.)
• Page Start: 1423
• Page End: 1427
• Publication Date: 2013-11
• Subjects: Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1185/03007995.2013.832186
• Languages: English
• ISSNs: 0300-7995

Abstract

<abstract> <title>Abstract</title> <sec id="ss1"> <title>Objective:</title> <p>Often, as diabetes mellitus type 2 (T2DM) evolves insidiously, prevention is commenced late and diagnosis is made when vascular damage has been set. Hence, our hypothesis is that T2DM awareness may influence the outcome of atherothrombotic events.</p> </sec> <sec id="ss2"> <title>Methods:</title> <p>A consecutive cohort of patients manifesting ST-elevation myocardial infarction (MI) was classified according to the presence and awareness of the diagnosis of T2DM: known diabetes (kT2DM, <italic>n</italic> = 72), unknown diabetes (uT2DM, <italic>n</italic> = 80) and no diabetes (ND, <italic>n</italic> = 333). Medical history, laboratory data, and angiographic findings including myocardial blush grade (MBG) were prospectively obtained. The primary endpoint was in-hospital death and secondary endpoint was major adverse cardiac events (MACE) defined as sudden cardiac death, fatal MI and nonfatal MI that occurred from 30 days of study entry onwards.</p> </sec> <sec id="ss3"> <title>Results:</title> <p>With the exception of glycated hemoglobin (<italic>p</italic> = 0.001) and triglycerides (<italic>p</italic> = 0.04), no differences were found between groups for all other biochemical, clinical or angiographic admission characteristics. Myocardial tissue reperfusion defined as MBG 3 was observed in 62% in the ND group, 50% in the kT2DM group and 23% in the uT2DM group (<italic>p</italic> = 0.01). All-cause in-hospital mortality was higher in uT2DM (16.7%) than in kT2DM (8.4%) and both groups had a higher mortality rate as compared with the ND group (3.8%, <italic>p</italic> = 0.01). During follow-up (653 ± 26 days), the incidence of MACE was higher in uT2DM than in kT2DM and in both compared to the ND group (<italic>p</italic> = 0.002).</p> </sec> <sec id="ss4"> <title>Conclusion:</title> <p>Unawareness of T2DM diagnosis is strongly associated with a poor short- and long-term outcome after MI.</p> </sec> </abstract>