Age-related difference in the impact of diabetes mellitus on all-cause mortality after acute myocardial infarction - 27/07/22
, Kye Taek Ahn a, 1, Mi Joo Kim a, Seok-Woo Seong a, Si Wan Choi a, Hyeon-Cheol Gwon b, Seung-Ho Hur c, Seung-Woon Rha d, Chang-Hwan Yoon e, Myung Ho Jeong f, Jin-Ok Jeong a, ⁎ KAMIR-NIH Investigators
Highlights |
• | Diabetes mellitus (DM) is highly prevalent among individuals hospitalized with acute myocardial infarction (AMI) and is associated with increased risk for long-term mortality.
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• | Over a median follow-up of three years, diabetes was associated with a 32% higher all-cause mortality after adjusting for multiple covariates in the entire cohort.
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• | These findings highlight the need for more aggressive therapies aimed at preventing future adverse cardiovascular events in young patients post-AMI.
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Abstract |
Aim |
To test the hypothesis that the impact of diabetes mellitus on clinical outcomes after acute myocardial infarction (AMI) can vary by age.
Methods |
A total of 12,600 AMI patients from the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) between November 2011 and December 2015 was classified into young (n = 3,590 [29%]) and old (n = 9,010 [72%]). Those less than 55 years of age were considered young. We performed comparisons of baseline characteristics, in-hospital treatments, and 3-year clinical outcomes between patients with and without diabetes after stratification according to age group.
Results |
The prevalence of diabetes mellitus was 27% in the young AMI group. In the multivariable adjusted model of the entire cohort, diabetes mellitus was associated strongly with 3-year all-cause mortality (13% vs. 6.8%; adjusted hazard ratio [HR], 1.318; 95% confidence interval [CI], 1.138–1.526; P<0.001). When the entire cohort was subdivided into two age groups, young diabetic patients showed a 107% higher mortality rate than those without diabetes (adjusted HR, 2.07 [1.15–3.72]; P = 0.015). Meanwhile, old diabetic patients had a 25% higher risk of mortality than non-diabetic patients (adjusted HR, 1.25 [1.08–1.46]; P = 0.004). The interaction of diabetes with age was significant (adjusted P for interaction = 0.008).
Conclusions |
Diabetes mellitus is not uncommon in younger AMI patients, and the relative risk of 3-year mortality is significantly higher in young patients than in older counterparts. More aggressive treatments are needed to prevent future cardiovascular events in younger patients after AMI.
Le texte complet de cet article est disponible en PDF.Keywords : Acute myocardial infarction, Diabetes mellitus, Age, Prognosis
List of abbreviations : AMI, CI, DM, HR, KAMIR-NIH, MACE, PCI, RAAS
Plan
Vol 48 - N° 4
Article 101349- juillet 2022 Retour au numéro
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