| Effects of insulin treatment on cause-specific one-year mortality and morbidity in diabetic patients with acute myocardial infarction. DIGAMI Study Group. Diabetes Insulin-Glucose in Acute Myocardial Infarction. | |
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MedLine Citation:
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PMID: 8880018 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Diabetic patients with acute myocardial infarction have a poor prognosis, which has been attributed to a higher incidence of congestive heart failure and fatal reinfarction. This study reports on the one-year morbidity and mortality in a randomized study with the aim of testing whether insulin-glucose infusion initiated as soon as possible after onset of myocardial infarction and followed by long-term subcutaneous insulin treatment may have a beneficial effect on outcome in diabetic patients. In all, 306 patients were recruited to the insulin-treated group, while 314 patients served as controls. The overall mortality after one year was 19% in the insulin group compared to 26% among controls (P < 0.05). The treatment effect was most pronounced in patients without prior insulin medication and at low cardiovascular risk. In this stratum the in-hospital mortality was reduced by 58% (P < 0.05) and the one-year mortality by 52% (P < 0.02). The most frequent cause of death in all patients was congestive heart failure (66%), but cardiovascular mortality (congestive heart failure, fatal reinfarction, sudden death and stroke) tended to be decreased in insulin-treated patients. However, this difference did not reach the level of statistical significance. The number of reinfarctions was 53 (28% fatal) in the insulin group compared to 55 (45% fatal) in the control group. The two groups did not differ as regards need for hospital care or coronary revascularization during the year of follow-up. In summary, left ventricular failure and fatal reinfarctions contribute to increased mortality in diabetic patients following acute myocardial infarction. Intensive insulin treatment lowered this mortality during one year of follow-up. |
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Authors:
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K Malmberg; L Rydén; A Hamsten; J Herlitz; A Waldenström; H Wedel |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European heart journal Volume: 17 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 1996 Sep |
Date Detail:
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Created Date: 1997-01-30 Completed Date: 1997-01-30 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 1337-44 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Karolinska Sjukhuset, Stockholm, Sweden. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Diabetes Mellitus, Type 1 / complications*, drug therapy*, physiopathology Female Humans Infusions, Intravenous Insulin / administration & dosage, therapeutic use* Male Middle Aged Morbidity Myocardial Infarction / complications, drug therapy*, epidemiology* Prognosis Prospective Studies Survival Rate Sweden |
| Chemical | |
Reg. No./Substance:
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11061-68-0/Insulin |
| Comments/Corrections | |
Comment In:
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Eur Heart J. 1996 Sep;17(9):1298-301
[PMID:
8880010
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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