Document Detail


Sudden cardiac death after myocardial infarction in patients with type 2 diabetes.
MedLine Citation:
PMID:  20682359     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Type 2 diabetes mellitus is a well-established risk factor for atherosclerosis, but its contribution to sudden cardiac death (SCD) risk after myocardial infarction (MI) is not well defined.
OBJECTIVE: The purpose of this study was to compare the incidence and time-dependent risk of SCD in diabetic patients versus nondiabetic patients during 5-year follow-up after acute MI.
METHODS: A total of 3,276 patients were enrolled at the time of acute MI between 1996 and 2005. Mean age at entry was 60 ± 11 years, and the cohort was followed until 2009. At entry into the study, diabetes was present in 629 (19.2%) patients. The primary endpoint was SCD, and the secondary endpoints were non-SCD and all-cause mortality.
RESULTS: Among diabetic patients, the incidence of SCD was higher (5.9%) than in nondiabetic patients (1.7%), with a hazard ratio (HR) of 3.8 (95% confidence interval [CI] 2.4-5.8; P <.001) and adjusted HR of 2.3 (95% CI 1.4-3.8; P <.01). In diabetic patients with left ventricular ejection fraction >35%, the incidence of SCD was nearly identical to that of nondiabetic patients with ventricular ejection fraction ≤35% (4.1% vs 4.9%; P = .48). An excess in the incidence of non-SCD began to appear among diabetic patients within the first 6 months of follow-up (P <.001) but not in the incidence of SCD (P = .09). The excess in SCD among diabetic patients began to appear more than 6 months after the index event.
CONCLUSION: Patients with type 2 diabetes are at higher risk for SCD after MI than are nondiabetic patients. The incidence of SCD in post-MI type 2 diabetic patients with left ventricular ejection fraction >35% is equal to that of nondiabetic patients with left ventricular ejection fraction <35%.
Authors:
M Juhani Junttila; Petra Barthel; Robert J Myerburg; Timo H Mäkikallio; Axel Bauer; Kurt Ulm; Antti Kiviniemi; Mikko Tulppo; Juha S Perkiömäki; Georg Schmidt; Heikki V Huikuri
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-01
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  7     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1396-403     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Institute of Clinical Medicine, Department of Internal Medicine, University of Oulu, Oulu, Finland. jjunttila@med.miami.edu
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Comment In:
Heart Rhythm. 2010 Oct;7(10):1404-5   [PMID:  20797459 ]

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