Clinical characteristics and prognostic implications of diabetes and myocardial injury in patients admitted to the emergency room.
Aged
Aged, 80 and over
Biomarkers
/ blood
Diabetes Mellitus
/ diagnosis
Disease Progression
Emergency Service, Hospital
Female
Heart Failure
/ diagnosis
Humans
Male
Middle Aged
Myocardial Infarction
/ diagnosis
Patient Admission
Patient Readmission
Prognosis
Retrospective Studies
Risk Assessment
Risk Factors
Spain
/ epidemiology
Time Factors
Troponin I
/ blood
Cardiac troponin
Diabetes
Mortality
Myocardial injury
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
30 08 2021
30 08 2021
Historique:
received:
27
05
2021
accepted:
23
08
2021
entrez:
31
8
2021
pubmed:
1
9
2021
medline:
22
12
2021
Statut:
epublish
Résumé
This study aimed to investigate the clinical features and prognosis of diabetes and myocardial injury in patients admitted to the emergency department. We analyzed the clinical data of all consecutive patients admitted to the emergency department during the years 2012 and 2013 with at least 1 cardiac Troponin I (cTnI Ultra Siemens, Advia Centaur) determination, and were classified according to the status of diabetes mellitus (DM) and myocardial injury (MI). Clinical events were evaluated in a 4-year follow-up. A total of 3622 patients were classified according to the presence of DM (n = 924 (25.55%)) and MI (n = 1049 (28.96%)). The proportion of MI in patients with DM was 40% and 25% in patients without DM. Mortality during follow-up was 10.9% in non-DM patients without MI, 21.3% in DM patients without MI, 40.1% in non-DM patients with MI, and 52.8% in DM patients with MI. A competitive risk model was used to obtain the Hazard Ratio (HR) for readmission for myocardial infarction or heart failure. There was a similar proportion of readmission for myocardial infarction and heart failure at a four-year follow-up in patients with DM or MI, which was much higher when DM was associated with MI, with respect to patients without DM or MI. The HR (95% Coefficient Interval) for myocardial infarction in the DM without MI, non-DM with MI, and DM with MI groups with respect to the non-DM without MI group was 2511 (1592-3960), 2682 (1739-4138), and 5036 (3221-7876), respectively. The HR (95% CI) for the risk of readmission for heart failure in the DM without MI, non-DM with MI, and DM with MI groups with respect to the non-DM without MI group was 2663 (1825-3886), 2562 (1753-3744) and 4292 (2936-6274), respectively. The association of DM and MI in patients treated in an Emergency Service identifies patients at very high risk of mortality and cardiovascular events.
Sections du résumé
BACKGROUND
This study aimed to investigate the clinical features and prognosis of diabetes and myocardial injury in patients admitted to the emergency department.
METHODS
We analyzed the clinical data of all consecutive patients admitted to the emergency department during the years 2012 and 2013 with at least 1 cardiac Troponin I (cTnI Ultra Siemens, Advia Centaur) determination, and were classified according to the status of diabetes mellitus (DM) and myocardial injury (MI). Clinical events were evaluated in a 4-year follow-up.
RESULTS
A total of 3622 patients were classified according to the presence of DM (n = 924 (25.55%)) and MI (n = 1049 (28.96%)). The proportion of MI in patients with DM was 40% and 25% in patients without DM. Mortality during follow-up was 10.9% in non-DM patients without MI, 21.3% in DM patients without MI, 40.1% in non-DM patients with MI, and 52.8% in DM patients with MI. A competitive risk model was used to obtain the Hazard Ratio (HR) for readmission for myocardial infarction or heart failure. There was a similar proportion of readmission for myocardial infarction and heart failure at a four-year follow-up in patients with DM or MI, which was much higher when DM was associated with MI, with respect to patients without DM or MI. The HR (95% Coefficient Interval) for myocardial infarction in the DM without MI, non-DM with MI, and DM with MI groups with respect to the non-DM without MI group was 2511 (1592-3960), 2682 (1739-4138), and 5036 (3221-7876), respectively. The HR (95% CI) for the risk of readmission for heart failure in the DM without MI, non-DM with MI, and DM with MI groups with respect to the non-DM without MI group was 2663 (1825-3886), 2562 (1753-3744) and 4292 (2936-6274), respectively.
CONCLUSIONS
The association of DM and MI in patients treated in an Emergency Service identifies patients at very high risk of mortality and cardiovascular events.
Identifiants
pubmed: 34461832
doi: 10.1186/s12872-021-02220-1
pii: 10.1186/s12872-021-02220-1
pmc: PMC8404360
doi:
Substances chimiques
Biomarkers
0
Troponin I
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
414Informations de copyright
© 2021. The Author(s).
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