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Diabetes mellitus unawareness is a strong determinant of mortality in patients manifesting myocardial infarction.
MedLine Citation:
PMID:  23927444     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective. 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. Methods. 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, n=72), unknown diabetes (uT2DM, n=80) and no diabetes (ND, n=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. Results. With the exception of glycated hemoglobin (p=0.001) and triglycerides (p=0.04), no differences were found between groups for all other biochemical, clinical or angiographic admission characteristics. Myocardial tissue reperfusion as defined as MBG 3 was observed in 62% in ND, 50% in kT2DM and 23% in uT2DM groups (p=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%, p=0.01). During follow-up (653 ± 26 days), the incidence of MACE was higher in uT2DM than in kT2DM and in both as compared to the ND group (p=0.002). Conclusion. Unawareness of T2DM diagnosis is strongly associated with a poor short- and long-term outcome after MI.
Authors:
Valéria N Figueiredo; Filipe Canela de Souza Godoi; Nestor S Martins; Jose C Quinaglia E Silva; Wilson Nadruz-Jr; Otavio R Coelho; Andrei C Sposito;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-8-8
Journal Detail:
Title:  Current medical research and opinion     Volume:  -     ISSN:  1473-4877     ISO Abbreviation:  Curr Med Res Opin     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-8-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0351014     Medline TA:  Curr Med Res Opin     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Cardiology Division, Faculty of Medical Sciences, University of Campinas (Unicamp), Campinas, SP, Brazil.
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