Deleterious synergistic effects of acute heart failure and diabetes mellitus in patients with acute coronary syndrome: Data from the FAST-MI Registries.
Acute heart failure
Acute myocardial infarction
Diabetes mellitus
Diabète
Infarctus aigu du myocarde
Insuffisance cardiaque aiguë
Long-term outcomes
Résultats à long terme
Journal
Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
03
10
2021
revised:
04
02
2022
accepted:
09
02
2022
pubmed:
20
3
2022
medline:
9
6
2022
entrez:
19
3
2022
Statut:
ppublish
Résumé
Diabetes mellitus (DM) predisposes patients to acute myocardial infarction (AMI) and acute heart failure (AHF). To assess correlates of AHF occurring at the early stage of AMI and synergism between early AHF and DM on 5-year mortality. FAST-MI 2005 and 2010 included 7839 consecutive patients admitted for AMI. Overall, 2151 patients (27.4%) had a history of diabetes mellitus (DM), of whom 629 (29.2%) were on insulin. Patients with versus without DM were older (mean age: 70.0 vs. 64.7years; P<0.001), with more comorbidities and more severe coronary artery disease. Early AHF (pulmonary oedema or cardiogenic shock) was the most frequent in-hospital complication (12.5%) and was twice as frequent in patients with versus without DM (20.2% vs. 9.6%; adjusted odds ratio: 1.66, 95% confidence interval [CI]: 1.43-1.94; P<0.001). Among in-hospital survivors, patients with DM without AHF and those with AHF without DM had 50% increases in 5-year mortality (adjusted hazard ratio [aHR]: 1.50, 95% CI: 1.32-1.69 and aHR: 1.46, 95% CI: 1.23-1.74; both P<0.001) versus patients without DM or AHF; with the risk among those with DM and AHF being doubled (aHR: 1.97, 95% CI: 1.66-2.34; P<0.0001). Early AHF is the most frequent complication of AMI and is twice as common in patients with versus without DM. After adjustment, early AHF and DM are associated with reduced 5-year survival with synergistic effects in patients with both conditions. https://clinicaltrials.gov (NCT00673036 and NCT01237418).
Sections du résumé
BACKGROUND
BACKGROUND
Diabetes mellitus (DM) predisposes patients to acute myocardial infarction (AMI) and acute heart failure (AHF).
AIMS
OBJECTIVE
To assess correlates of AHF occurring at the early stage of AMI and synergism between early AHF and DM on 5-year mortality.
METHODS
METHODS
FAST-MI 2005 and 2010 included 7839 consecutive patients admitted for AMI.
RESULTS
RESULTS
Overall, 2151 patients (27.4%) had a history of diabetes mellitus (DM), of whom 629 (29.2%) were on insulin. Patients with versus without DM were older (mean age: 70.0 vs. 64.7years; P<0.001), with more comorbidities and more severe coronary artery disease. Early AHF (pulmonary oedema or cardiogenic shock) was the most frequent in-hospital complication (12.5%) and was twice as frequent in patients with versus without DM (20.2% vs. 9.6%; adjusted odds ratio: 1.66, 95% confidence interval [CI]: 1.43-1.94; P<0.001). Among in-hospital survivors, patients with DM without AHF and those with AHF without DM had 50% increases in 5-year mortality (adjusted hazard ratio [aHR]: 1.50, 95% CI: 1.32-1.69 and aHR: 1.46, 95% CI: 1.23-1.74; both P<0.001) versus patients without DM or AHF; with the risk among those with DM and AHF being doubled (aHR: 1.97, 95% CI: 1.66-2.34; P<0.0001).
CONCLUSION
CONCLUSIONS
Early AHF is the most frequent complication of AMI and is twice as common in patients with versus without DM. After adjustment, early AHF and DM are associated with reduced 5-year survival with synergistic effects in patients with both conditions.
CLINICAL TRIAL REGISTRATION
BACKGROUND
https://clinicaltrials.gov (NCT00673036 and NCT01237418).
Identifiants
pubmed: 35304066
pii: S1875-2136(22)00038-9
doi: 10.1016/j.acvd.2022.02.004
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT01237418', 'NCT00673036']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
264-275Informations de copyright
Copyright © 2022 Elsevier Masson SAS. All rights reserved.