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Comparison of Clinical Outcomes Following Acute Myocardial Infarctions in Hypertensive Patients With or Without Diabetes

BACKGROUND AND OBJECTIVES: It is thought that patients with diabetes mellitus (DM) have a poor prognosis after an acute myocardial infarction (AMI), but the effect of diabetes on the outcomes of hypertensive patients with AMIs has not been elucidated in the Korean population. The aim of this study w...

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Autores principales: Lee, Min Goo, Jeong, Myung Ho, Ahn, Youngkeun, Chae, Shung Chull, Hur, Seung Ho, Hong, Taek Jong, Kim, Young Jo, Seong, In Whan, Chae, Jei Keon, Rhew, Jay Young, Chae, In Ho, Cho, Myeong Chan, Bae, Jang Ho, Rha, Seung Woon, Kim, Chong Jim, Choi, Donghoon, Jang, Yang Soo, Yoon, Junghan, Chung, Wook Sung, Cho, Jeong Gwan, Seung, Ki Bae, Park, Seung Jung
Formato: Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771834/
https://www.ncbi.nlm.nih.gov/pubmed/19949630
http://dx.doi.org/10.4070/kcj.2009.39.6.243
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author Lee, Min Goo
Jeong, Myung Ho
Ahn, Youngkeun
Chae, Shung Chull
Hur, Seung Ho
Hong, Taek Jong
Kim, Young Jo
Seong, In Whan
Chae, Jei Keon
Rhew, Jay Young
Chae, In Ho
Cho, Myeong Chan
Bae, Jang Ho
Rha, Seung Woon
Kim, Chong Jim
Choi, Donghoon
Jang, Yang Soo
Yoon, Junghan
Chung, Wook Sung
Cho, Jeong Gwan
Seung, Ki Bae
Park, Seung Jung
author_facet Lee, Min Goo
Jeong, Myung Ho
Ahn, Youngkeun
Chae, Shung Chull
Hur, Seung Ho
Hong, Taek Jong
Kim, Young Jo
Seong, In Whan
Chae, Jei Keon
Rhew, Jay Young
Chae, In Ho
Cho, Myeong Chan
Bae, Jang Ho
Rha, Seung Woon
Kim, Chong Jim
Choi, Donghoon
Jang, Yang Soo
Yoon, Junghan
Chung, Wook Sung
Cho, Jeong Gwan
Seung, Ki Bae
Park, Seung Jung
author_sort Lee, Min Goo
collection PubMed
description BACKGROUND AND OBJECTIVES: It is thought that patients with diabetes mellitus (DM) have a poor prognosis after an acute myocardial infarction (AMI), but the effect of diabetes on the outcomes of hypertensive patients with AMIs has not been elucidated in the Korean population. The aim of this study was to investigate the effects of diabetes on long-term clinical outcomes following AMIs in patients with hypertension. SUBJECTS AND METHODS: Using data from the Korea Acute Myocardial Infarction Registry (November 2005 to December 2006), 2,233 hypertensive patients with AMIs were grouped as follows based on the presence of DM: group I, diabetic hypertension (n=892, 544 men, mean age=66.2±10.9 years); and group II, non-diabetic hypertension (n=1341, 938 men, mean age=63.9±12.8 years). The primary study outcomes included in-hospital death and major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), repeat percutaneous coronary intervention, and coronary artery bypass surgery) at the 1 year follow-up. RESULTS: Hypertensive patients with DM were older and more likely to be women. The diabetic group had lower blood pressure (p<0.001), a lower left ventricular ejection fraction (p<0.001), a more severe degree of heart failure (p<0.001), a longer duration of coronary care unit admission (p<0.001), and a higher incidence of hyperlipidemia (p=0.007). The N-terminal pro-brain natriuretic peptide level (4602.5±8710.6 pg/mL vs. 2320.8±5837.9 pg/mL, p<0.001) was higher and the creatinine clearance (62.4±29.9 mL/min vs. 73.0±40.8 mL/min, p<0.001) was lower in the diabetic group than the non-diabetic group. Coronary angiographic findings revealed more frequent involvement of the left main stem (p=0.002) and multiple vessels (p<0.001) in the diabetic group. The rate of in-hospital death was higher in the diabetic group (p<0.001). During follow-up, the rates of composite MACE at 1 month, 6 months, and 12 months were higher in the diabetic group (p<0.001). CONCLUSION: In hypertensive patients with AMI, DM was associated with worse clinical and angiographic features, with a higher risk of development of severe heart failure, and an increased risk of MACE on long-term clinical follow-up.
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spelling pubmed-27718342009-11-30 Comparison of Clinical Outcomes Following Acute Myocardial Infarctions in Hypertensive Patients With or Without Diabetes Lee, Min Goo Jeong, Myung Ho Ahn, Youngkeun Chae, Shung Chull Hur, Seung Ho Hong, Taek Jong Kim, Young Jo Seong, In Whan Chae, Jei Keon Rhew, Jay Young Chae, In Ho Cho, Myeong Chan Bae, Jang Ho Rha, Seung Woon Kim, Chong Jim Choi, Donghoon Jang, Yang Soo Yoon, Junghan Chung, Wook Sung Cho, Jeong Gwan Seung, Ki Bae Park, Seung Jung Korean Circ J Original Article BACKGROUND AND OBJECTIVES: It is thought that patients with diabetes mellitus (DM) have a poor prognosis after an acute myocardial infarction (AMI), but the effect of diabetes on the outcomes of hypertensive patients with AMIs has not been elucidated in the Korean population. The aim of this study was to investigate the effects of diabetes on long-term clinical outcomes following AMIs in patients with hypertension. SUBJECTS AND METHODS: Using data from the Korea Acute Myocardial Infarction Registry (November 2005 to December 2006), 2,233 hypertensive patients with AMIs were grouped as follows based on the presence of DM: group I, diabetic hypertension (n=892, 544 men, mean age=66.2±10.9 years); and group II, non-diabetic hypertension (n=1341, 938 men, mean age=63.9±12.8 years). The primary study outcomes included in-hospital death and major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), repeat percutaneous coronary intervention, and coronary artery bypass surgery) at the 1 year follow-up. RESULTS: Hypertensive patients with DM were older and more likely to be women. The diabetic group had lower blood pressure (p<0.001), a lower left ventricular ejection fraction (p<0.001), a more severe degree of heart failure (p<0.001), a longer duration of coronary care unit admission (p<0.001), and a higher incidence of hyperlipidemia (p=0.007). The N-terminal pro-brain natriuretic peptide level (4602.5±8710.6 pg/mL vs. 2320.8±5837.9 pg/mL, p<0.001) was higher and the creatinine clearance (62.4±29.9 mL/min vs. 73.0±40.8 mL/min, p<0.001) was lower in the diabetic group than the non-diabetic group. Coronary angiographic findings revealed more frequent involvement of the left main stem (p=0.002) and multiple vessels (p<0.001) in the diabetic group. The rate of in-hospital death was higher in the diabetic group (p<0.001). During follow-up, the rates of composite MACE at 1 month, 6 months, and 12 months were higher in the diabetic group (p<0.001). CONCLUSION: In hypertensive patients with AMI, DM was associated with worse clinical and angiographic features, with a higher risk of development of severe heart failure, and an increased risk of MACE on long-term clinical follow-up. The Korean Society of Cardiology 2009-06 2009-06-30 /pmc/articles/PMC2771834/ /pubmed/19949630 http://dx.doi.org/10.4070/kcj.2009.39.6.243 Text en Copyright © 2009 The Korean Society of Cardiology http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Min Goo
Jeong, Myung Ho
Ahn, Youngkeun
Chae, Shung Chull
Hur, Seung Ho
Hong, Taek Jong
Kim, Young Jo
Seong, In Whan
Chae, Jei Keon
Rhew, Jay Young
Chae, In Ho
Cho, Myeong Chan
Bae, Jang Ho
Rha, Seung Woon
Kim, Chong Jim
Choi, Donghoon
Jang, Yang Soo
Yoon, Junghan
Chung, Wook Sung
Cho, Jeong Gwan
Seung, Ki Bae
Park, Seung Jung
Comparison of Clinical Outcomes Following Acute Myocardial Infarctions in Hypertensive Patients With or Without Diabetes
title Comparison of Clinical Outcomes Following Acute Myocardial Infarctions in Hypertensive Patients With or Without Diabetes
title_full Comparison of Clinical Outcomes Following Acute Myocardial Infarctions in Hypertensive Patients With or Without Diabetes
title_fullStr Comparison of Clinical Outcomes Following Acute Myocardial Infarctions in Hypertensive Patients With or Without Diabetes
title_full_unstemmed Comparison of Clinical Outcomes Following Acute Myocardial Infarctions in Hypertensive Patients With or Without Diabetes
title_short Comparison of Clinical Outcomes Following Acute Myocardial Infarctions in Hypertensive Patients With or Without Diabetes
title_sort comparison of clinical outcomes following acute myocardial infarctions in hypertensive patients with or without diabetes
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771834/
https://www.ncbi.nlm.nih.gov/pubmed/19949630
http://dx.doi.org/10.4070/kcj.2009.39.6.243
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