Comparison of frequency of periprocedural myocardial infarction in patients with and without diabetes mellitus to those with previously unknown but elevated glycated hemoglobin levels (from the TWENTE Trial).
نویسندگان
چکیده
In patients without a history of diabetes mellitus, increased levels of glycated hemoglobin (HbA1c) are associated with higher cardiovascular risk. The relation between undetected diabetes and clinical outcome after percutaneous coronary intervention is unknown. To investigate whether these patients may have an increased risk of periprocedural myocardial infarction (PMI), the most frequent adverse event after percutaneous coronary intervention, we assessed patients of the TWENTE trial (a randomized, controlled, second-generation drug-eluting stent trial) in whom HbA1c data were available. Patients were classified as known diabetics or patients without a history of diabetes who were subdivided into undetected diabetics (HbA1c ≥6.5%) and nondiabetics (HbA1c <6.5%). Systematic measurement of cardiac biomarkers and electrocardiographic assessment were performed. One-year clinical outcome was also compared. Of 626 patients, 44 (7%) were undetected diabetics, 181 (29%) were known diabetics, and 401 (64%) were nondiabetics. In undetected diabetics the PMI rate was higher than in nondiabetics (13.6% vs 3.7%, p = 0.01) and known diabetics (13.6% vs 6.1%, p = 0.11). Multivariate analysis adjusting for covariates confirmed a significantly higher PMI risk in undetected diabetics compared to nondiabetics (odds ratio 6.13, 95% confidence interval 2.07 to 18.13, p = 0.001) and known diabetics (odds ratio 3.73, 95% confidence interval 1.17 to 11.89, p = 0.03). After 1 year, target vessel MI rate was significantly higher in undetected diabetics (p = 0.02) than in nondiabetics, which was related mainly to differences in PMI. Target vessel failure was numerically larger in unknown diabetics than in nondiabetics, but this difference did not reach statistical significance (13.6% vs 8.0%, p = 0.25). In conclusion, undetected diabetics were shown to have an increased risk of PMI.
منابع مشابه
Trends in the Prevalence of Diabetes Mellitus in Patients with Myocardial Infarction in the South of Iran: 2008 to 2014
Background: Diabetes mellitus is a strong risk factor for cardiovascular disease, including acute myocardial infarction (AMI). Management of risk factors and the other prevention services in recent years lead to a significant decrease in AMI incidence. However, to examine the success of those strategies to control diabetes, this study aimed to identify the trends in prevalence of diabetes melli...
متن کاملCorrelation between Glycated Hemoglobin, Serum Glucose and Serum Lipid Levels in Type 2 Diabetes
Abstract Objective: Diabetes mellitus is the most common metabolic disease. One of the most common problems in diabetic patients is atherosclerotic cardiovascular disease which is induced by hyperlipidemia. Impaired lipid metabolism resulting from uncontrolled hyperglycemia has been implicated in cardiovascular complications in diabetic patients. Also, glycated hemoglobin (HbA1c) has been rega...
متن کاملEarly myocardial infarction and its risk factors in patients admitted in Rasul-e-Akram Hospital
Introduction: Following urbanization of developing world and increase in prevalence of risk factors for Ischemic Heart Diseases (IHD), the major global burden of IHD is in low and middle income countries. This study was designed to determine trends in early MI (Myocardial Infarction) during ten years and comparison of its risk factors with other patients with MI. Methods: In this cross-s...
متن کاملThe Effect of Probiotic Yogurt on Blood Glucose and cardiovascular Biomarkers in Patients with Type II Diabetes: A Randomized Controlled Trial
Background: Given the high prevalence of type II diabetes and its complications, the evidence regarding the beneficial effects of probiotic yogurt on some cardiovascular biomarkers in diabetic patients is worthy of investigation. Aim: To investigate the effect of probiotic yogurt on blood glucose level and cardiovascular biomarkers in patients with type II diabetes. Method:This randomized, clin...
متن کاملThe Prevalence of Limited Joint Mobility in Patients with Type I Diabetes Mellitus in Kerman
Background & Aims: Limited joint mobility (LJM) is a complication of diabetes mellitus, which usually begins from the small joints of hands and is associated with long-term complications of diabetes, such as retinopathy and nephropathy. The aim of this study was to find the prevalence of Limited Joint Mobility in patients with type 1 diabetes mellitus in Kerman in 2003. Methods: Sixty-six patie...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The American journal of cardiology
دوره 110 11 شماره
صفحات -
تاریخ انتشار 2012