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Titolo:
RANDOMIZED TRIAL OF INSULIN-GLUCOSE INFUSION FOLLOWED BY SUBCUTANEOUSINSULIN-TREATMENT IN DIABETIC-PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION (DIGAMI STUDY) - EFFECTS ON MORTALITY AT 1 YEAR
Autore:
MALMBERG K; RYDEN L; EFENDIC S; HERLITZ J; NICOL P; WALDENSTROM A; WEDEL H; WELIN L;
Indirizzi:
KAROLINSKA HOSP,DEPT CARDIOL S-17176 STOCKHOLM SWEDEN
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 1, volume: 26, anno: 1995,
pagine: 57 - 65
SICI:
0735-1097(1995)26:1<57:RTOIIF>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
METABOLIC RESPONSES; DEPENDENT DIABETICS; LIPID-METABOLISM; HEART; MELLITUS; HYPOGLYCEMIA; METOPROLOL; DISEASE; CARDIOMYOPATHY; CARBOHYDRATE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
70
Recensione:
Indirizzi per estratti:
Citazione:
K. Malmberg et al., "RANDOMIZED TRIAL OF INSULIN-GLUCOSE INFUSION FOLLOWED BY SUBCUTANEOUSINSULIN-TREATMENT IN DIABETIC-PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION (DIGAMI STUDY) - EFFECTS ON MORTALITY AT 1 YEAR", Journal of the American College of Cardiology, 26(1), 1995, pp. 57-65

Abstract

Objectives. We tested how insulin-glucose infusion followed by multidose insulin treatment in diabetic patients with acute myocardial infarction affected mortality during the subsequent 12 months of follow-up. Background. Despite significant improvements in acute coronary care, diabetic patients with acute myocardial infarction still have a high mortality rate. Methods. A total of 620 patients were studied: 306 randomized to treatment with insulin-glucose infusion followed by multidose subcutaneous insulin for greater than or equal to 3 months and 314 to conventional therapy. Results. The two groups were well matched for baseline characteristics. Blood glucose decreased from 15.4 +/- 4.1 to9.6 +/- 3.3 mmol/liter (mean +/- SD) in the infusion group during the1st 24 h, and from 15.7 +/- 4.2 to 11.7 +/- 4.1 among control patients (p < 0.0001). After 1 year 57 subjects (18.6%) in the infusion groupand 82 (26.1%) in the control group had died (relative mortality reduction 29%, p = 0.027). The mortality reduction was particularly evident in patients who had a low cardiovascular risk profile and no previous insulin treatment (3-month mortality rate 6.5% in the infusion groupvs. 13.5% in the control group [relative reduction 52%, p = 0.046]; 1-year mortality rate 8.6% in the infusion group vs. 18.0% in the control group [relative reduction 52%, p = 0.020]). Conclusions. Insulin-glucose infusion followed by a multidose insulin regimen improved long-term prognosis in diabetic patients with acute myocardial infarction.

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Documento generato il 05/12/20 alle ore 19:57:10