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Titolo:
EFFECTS OF INSULIN-TREATMENT ON CAUSE-SPECIFIC ONE-YEAR MORTALITY ANDMORBIDITY IN DIABETIC-PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION
Autore:
MALMBERG K; RYDEN L; HAMSTEN A; HERLITZ J; WALDENSTROM A; WEDEL H;
Indirizzi:
KAROLINSKA HOSP,DEPT CARDIOL,BOX 110 S-17176 STOCKHOLM SWEDEN KAROLINSKA HOSP,DEPT MED S-17176 STOCKHOLM SWEDEN SAHLGRENS HOSP,DEPT MED GOTHENBURG SWEDEN NORRLANDS UNIV SJUKHUS,DEPT MED UMEA SWEDEN NORDISKA HALSOVARDSHOGSKOLAM GOTHENBURG SWEDEN
Titolo Testata:
European heart journal
fascicolo: 9, volume: 17, anno: 1996,
pagine: 1337 - 1344
SICI:
0195-668X(1996)17:9<1337:EOIOCO>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLASMINOGEN-ACTIVATOR INHIBITOR; CONGESTIVE HEART-FAILURE; THROMBOLYTIC THERAPY; METABOLIC RESPONSES; GLUCOSE INFUSION; MELLITUS; PROGNOSIS; DISEASE; CARDIOMYOPATHY; PROPRANOLOL;
Keywords:
DIABETES MELLITUS; ACUTE MYOCARDIAL INFARCTION; INSULIN TREATMENT; MORBIDITY; MORTALITY; PROGNOSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
40
Recensione:
Indirizzi per estratti:
Citazione:
K. Malmberg et al., "EFFECTS OF INSULIN-TREATMENT ON CAUSE-SPECIFIC ONE-YEAR MORTALITY ANDMORBIDITY IN DIABETIC-PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION", European heart journal, 17(9), 1996, pp. 1337-1344

Abstract

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 andstroke) 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 andfatal reinfarctions contribute to increased mortality in diabetic patients following acute myocardial infarction. Intensive insulin treatment lowered this mortality during one year of follow-up.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 10:11:24