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Titolo:
Impact of diabetes on long-term survival after acute myocardial infarction- Comparability of risk with prior myocardial infarction
Autore:
Mukamal, KJ; Nesto, RW; Cohen, MC; Muller, JE; Maclure, M; Sherwood, JB; Mittleman, MA;
Indirizzi:
Beth Israel Deaconess Med Ctr, Dept Med, Div Gen Med & Primary Care, Boston, MA 02215 USA Beth Israel Deaconess Med Ctr Boston MA USA 02215 e, Boston, MA 02215 USA Lahey Clin Med Ctr, Dept Cardiovasc Med, Burlington, MA 01803 USA Lahey Clin Med Ctr Burlington MA USA 01803 Med, Burlington, MA 01803 USA Maine Med Ctr, Div Cardiol, Portland, ME 04102 USA Maine Med Ctr PortlandME USA 04102 , Div Cardiol, Portland, ME 04102 USA Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA Massachusetts Gen Hosp Boston MA USA 02114 Cardiol, Boston, MA 02114 USA Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 th, Dept Epidemiol, Boston, MA 02115 USA Harvard Univ, Sch Publ Hlth, Dept Hlth & Social Behav, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 lth & Social Behav, Boston, MA 02115 USA Beth Israel Deaconess Med Ctr, Div Cardiol, Boston, MA 02215 USA Beth Israel Deaconess Med Ctr Boston MA USA 02215 l, Boston, MA 02215 USA
Titolo Testata:
DIABETES CARE
fascicolo: 8, volume: 24, anno: 2001,
pagine: 1422 - 1427
SICI:
0149-5992(200108)24:8<1422:IODOLS>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY HEART-DISEASE; THROMBOLYTIC THERAPY; 10-YEAR SURVIVAL; MORTALITY; MELLITUS; PROGNOSIS; TRIAL; POPULATIONS; MANAGEMENT; EXPERIENCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Mukamal, KJ Beth Israel Deaconess Med Ctr, Dept Med, Div Gen Med & PrimaryCare, 330 Brookline Ave,LY-03, Boston, MA 02215 USA Beth Israel Deaconess Med Ctr 330 Brookline Ave,LY-03 Boston MA USA 02215
Citazione:
K.J. Mukamal et al., "Impact of diabetes on long-term survival after acute myocardial infarction- Comparability of risk with prior myocardial infarction", DIABET CARE, 24(8), 2001, pp. 1422-1427

Abstract

OBJECTIVE - To determine the effect of diabetes on long-term survival after acute myocardial infarction and to compare its effect with that of a previous myocardial infarction. RESEARCH DESIGN AND METHODS - In a prospective cohort study, we followed 1,935 patients hospitalized with a confirmed acute myocardial infarction at 45 U.S. medical centers between 1989 and 1993, as part of the Determinants of Myocardial Infarction Onset Study. Trained interviewers performed chart reviews and face-to-face interviews with all patients. We analyzed survivalusing Cox proportional hazards regression to control for potentially confounding factors. RESULTS - Of the 1,935 patients, 320 (17%) died during a mean follow-up of3.7 years. A total of 399 patients (21%) had previously diagnosed diabetes. Diabetes was associated with markedly higher total mortality in unadjusted (hazard ratio [HR] 2.4 95% Cl 1.9-3.0) and adjusted (1.7; 1.3-2.1) analyses. The magnitude of the effect of diabetes was identical to that of a previous myocardial infarction. The effect of diabetes was not significantly modified by age, smoking, household income, use of thrombolytic therapy, typeof hypoglycemic treatment, or duration of diabetes, but the risk associated with diabetes was higher among women than men (adjusted HRs 2.7 vs. 1.3, P = 0.01). CONCLUSIONS - Diabetes is associated with markedly increased mortality after acute myocardial infarction, particularly in women. The increase in riskis of the same magnitude as a previous myocardial infarction and provides further support for aggressive treatment of coronary risk factors among diabetic patients.

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Documento generato il 27/11/20 alle ore 07:00:23