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Diabetes mellitus unawareness is a strong determinant of mortality in patients manifesting myocardial infarction

Abstract Objective: Often, as diabetes mellitus type 2 (T2DM) evolves insidiously, prevention is commenced late and diagnosis is made when vascular damage has been set. Hence, our hypothesis is that T2DM awareness may influence the outcome of atherothrombotic events. Methods: A consecutive cohort of... Full description

Journal Title: Current medical research and opinion 2013, Vol.29 (11), p.1423-1427
Main Author: Figueiredo, Valéria N.
Other Authors: Godoi, Filipe Canela de Souza , Martins, Nestor S. , Quinaglia e Silva, Jose C. , Nadruz, Wilson , Coelho, Otavio R. , Sposito, Andrei C.
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: Colchester: Informa UK Ltd
ID: ISSN: 0300-7995
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recordid: cdi_crossref_primary_10_1185_03007995_2013_832186
title: Diabetes mellitus unawareness is a strong determinant of mortality in patients manifesting myocardial infarction
format: Article
creator:
  • Figueiredo, Valéria N.
  • Godoi, Filipe Canela de Souza
  • Martins, Nestor S.
  • Quinaglia e Silva, Jose C.
  • Nadruz, Wilson
  • Coelho, Otavio R.
  • Sposito, Andrei C.
subjects:
  • Awareness
  • Biological and medical sciences
  • Cardiology. Vascular system
  • Cohort Studies
  • Coronary Angiography
  • Coronary heart disease
  • Creatine Kinase - blood
  • Delayed Diagnosis - mortality
  • Diabetes
  • Diabetes Mellitus, Type 2 - diagnosis
  • Diabetes Mellitus, Type 2 - mortality
  • Diabetes. Impaired glucose tolerance
  • Endocrine pancreas. Apud cells (diseases)
  • Endocrinopathies
  • Etiopathogenesis. Screening. Investigations. Target tissue resistance
  • Female
  • Glycated Hemoglobin A - metabolism
  • Heart
  • Humans
  • Male
  • Medical sciences
  • Middle Aged
  • Mortality
  • Myocardial infarction
  • Myocardial Infarction - diagnostic imaging
  • Myocardial Infarction - mortality
  • Myocarditis. Cardiomyopathies
  • Pharmacology. Drug treatments
  • Prospective Studies
  • Treatment Outcome
  • Triglycerides - blood
  • Troponin - blood
ispartof: Current medical research and opinion, 2013, Vol.29 (11), p.1423-1427
description: Abstract Objective: Often, as diabetes mellitus type 2 (T2DM) evolves insidiously, prevention is commenced late and diagnosis is made when vascular damage has been set. Hence, our hypothesis is that T2DM awareness may influence the outcome of atherothrombotic events. Methods: A consecutive cohort of patients manifesting ST-elevation myocardial infarction (MI) was classified according to the presence and awareness of the diagnosis of T2DM: known diabetes (kT2DM, n = 72), unknown diabetes (uT2DM, n = 80) and no diabetes (ND, n = 333). Medical history, laboratory data, and angiographic findings including myocardial blush grade (MBG) were prospectively obtained. The primary endpoint was in-hospital death and secondary endpoint was major adverse cardiac events (MACE) defined as sudden cardiac death, fatal MI and nonfatal MI that occurred from 30 days of study entry onwards. Results: With the exception of glycated hemoglobin (p = 0.001) and triglycerides (p = 0.04), no differences were found between groups for all other biochemical, clinical or angiographic admission characteristics. Myocardial tissue reperfusion defined as MBG 3 was observed in 62% in the ND group, 50% in the kT2DM group and 23% in the uT2DM group (p = 0.01). All-cause in-hospital mortality was higher in uT2DM (16.7%) than in kT2DM (8.4%) and both groups had a higher mortality rate as compared with the ND group (3.8%, p = 0.01). During follow-up (653 ± 26 days), the incidence of MACE was higher in uT2DM than in kT2DM and in both compared to the ND group (p = 0.002). Conclusion: Unawareness of T2DM diagnosis is strongly associated with a poor short- and long-term outcome after MI.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0300-7995
fulltext: fulltext
issn:
  • 0300-7995
  • 1473-4877
url: Link


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titleDiabetes mellitus unawareness is a strong determinant of mortality in patients manifesting myocardial infarction
sourceAlma/SFX Local Collection
creatorFigueiredo, Valéria N. ; Godoi, Filipe Canela de Souza ; Martins, Nestor S. ; Quinaglia e Silva, Jose C. ; Nadruz, Wilson ; Coelho, Otavio R. ; Sposito, Andrei C.
creatorcontribFigueiredo, Valéria N. ; Godoi, Filipe Canela de Souza ; Martins, Nestor S. ; Quinaglia e Silva, Jose C. ; Nadruz, Wilson ; Coelho, Otavio R. ; Sposito, Andrei C. ; Brasilia Heart Study Group ; on behalf of the Brasilia Heart Study Group
descriptionAbstract Objective: Often, as diabetes mellitus type 2 (T2DM) evolves insidiously, prevention is commenced late and diagnosis is made when vascular damage has been set. Hence, our hypothesis is that T2DM awareness may influence the outcome of atherothrombotic events. Methods: A consecutive cohort of patients manifesting ST-elevation myocardial infarction (MI) was classified according to the presence and awareness of the diagnosis of T2DM: known diabetes (kT2DM, n = 72), unknown diabetes (uT2DM, n = 80) and no diabetes (ND, n = 333). Medical history, laboratory data, and angiographic findings including myocardial blush grade (MBG) were prospectively obtained. The primary endpoint was in-hospital death and secondary endpoint was major adverse cardiac events (MACE) defined as sudden cardiac death, fatal MI and nonfatal MI that occurred from 30 days of study entry onwards. Results: With the exception of glycated hemoglobin (p = 0.001) and triglycerides (p = 0.04), no differences were found between groups for all other biochemical, clinical or angiographic admission characteristics. Myocardial tissue reperfusion defined as MBG 3 was observed in 62% in the ND group, 50% in the kT2DM group and 23% in the uT2DM group (p = 0.01). All-cause in-hospital mortality was higher in uT2DM (16.7%) than in kT2DM (8.4%) and both groups had a higher mortality rate as compared with the ND group (3.8%, p = 0.01). During follow-up (653 ± 26 days), the incidence of MACE was higher in uT2DM than in kT2DM and in both compared to the ND group (p = 0.002). Conclusion: Unawareness of T2DM diagnosis is strongly associated with a poor short- and long-term outcome after MI.
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subjectAwareness ; Biological and medical sciences ; Cardiology. Vascular system ; Cohort Studies ; Coronary Angiography ; Coronary heart disease ; Creatine Kinase - blood ; Delayed Diagnosis - mortality ; Diabetes ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - mortality ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Glycated Hemoglobin A - metabolism ; Heart ; Humans ; Male ; Medical sciences ; Middle Aged ; Mortality ; Myocardial infarction ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - mortality ; Myocarditis. Cardiomyopathies ; Pharmacology. Drug treatments ; Prospective Studies ; Treatment Outcome ; Triglycerides - blood ; Troponin - blood
ispartofCurrent medical research and opinion, 2013, Vol.29 (11), p.1423-1427
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1Godoi, Filipe Canela de Souza
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4Nadruz, Wilson
5Coelho, Otavio R.
6Sposito, Andrei C.
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descriptionAbstract Objective: Often, as diabetes mellitus type 2 (T2DM) evolves insidiously, prevention is commenced late and diagnosis is made when vascular damage has been set. Hence, our hypothesis is that T2DM awareness may influence the outcome of atherothrombotic events. Methods: A consecutive cohort of patients manifesting ST-elevation myocardial infarction (MI) was classified according to the presence and awareness of the diagnosis of T2DM: known diabetes (kT2DM, n = 72), unknown diabetes (uT2DM, n = 80) and no diabetes (ND, n = 333). Medical history, laboratory data, and angiographic findings including myocardial blush grade (MBG) were prospectively obtained. The primary endpoint was in-hospital death and secondary endpoint was major adverse cardiac events (MACE) defined as sudden cardiac death, fatal MI and nonfatal MI that occurred from 30 days of study entry onwards. Results: With the exception of glycated hemoglobin (p = 0.001) and triglycerides (p = 0.04), no differences were found between groups for all other biochemical, clinical or angiographic admission characteristics. Myocardial tissue reperfusion defined as MBG 3 was observed in 62% in the ND group, 50% in the kT2DM group and 23% in the uT2DM group (p = 0.01). All-cause in-hospital mortality was higher in uT2DM (16.7%) than in kT2DM (8.4%) and both groups had a higher mortality rate as compared with the ND group (3.8%, p = 0.01). During follow-up (653 ± 26 days), the incidence of MACE was higher in uT2DM than in kT2DM and in both compared to the ND group (p = 0.002). Conclusion: Unawareness of T2DM diagnosis is strongly associated with a poor short- and long-term outcome after MI.
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1Biological and medical sciences
2Cardiology. Vascular system
3Cohort Studies
4Coronary Angiography
5Coronary heart disease
6Creatine Kinase - blood
7Delayed Diagnosis - mortality
8Diabetes
9Diabetes Mellitus, Type 2 - diagnosis
10Diabetes Mellitus, Type 2 - mortality
11Diabetes. Impaired glucose tolerance
12Endocrine pancreas. Apud cells (diseases)
13Endocrinopathies
14Etiopathogenesis. Screening. Investigations. Target tissue resistance
15Female
16Glycated Hemoglobin A - metabolism
17Heart
18Humans
19Male
20Medical sciences
21Middle Aged
22Mortality
23Myocardial infarction
24Myocardial Infarction - diagnostic imaging
25Myocardial Infarction - mortality
26Myocarditis. Cardiomyopathies
27Pharmacology. Drug treatments
28Prospective Studies
29Treatment Outcome
30Triglycerides - blood
31Troponin - blood
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titleDiabetes mellitus unawareness is a strong determinant of mortality in patients manifesting myocardial infarction
authorFigueiredo, Valéria N. ; Godoi, Filipe Canela de Souza ; Martins, Nestor S. ; Quinaglia e Silva, Jose C. ; Nadruz, Wilson ; Coelho, Otavio R. ; Sposito, Andrei C.
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1Biological and medical sciences
2Cardiology. Vascular system
3Cohort Studies
4Coronary Angiography
5Coronary heart disease
6Creatine Kinase - blood
7Delayed Diagnosis - mortality
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9Diabetes Mellitus, Type 2 - diagnosis
10Diabetes Mellitus, Type 2 - mortality
11Diabetes. Impaired glucose tolerance
12Endocrine pancreas. Apud cells (diseases)
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16Glycated Hemoglobin A - metabolism
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31Troponin - blood
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1Godoi, Filipe Canela de Souza
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abstractAbstract Objective: Often, as diabetes mellitus type 2 (T2DM) evolves insidiously, prevention is commenced late and diagnosis is made when vascular damage has been set. Hence, our hypothesis is that T2DM awareness may influence the outcome of atherothrombotic events. Methods: A consecutive cohort of patients manifesting ST-elevation myocardial infarction (MI) was classified according to the presence and awareness of the diagnosis of T2DM: known diabetes (kT2DM, n = 72), unknown diabetes (uT2DM, n = 80) and no diabetes (ND, n = 333). Medical history, laboratory data, and angiographic findings including myocardial blush grade (MBG) were prospectively obtained. The primary endpoint was in-hospital death and secondary endpoint was major adverse cardiac events (MACE) defined as sudden cardiac death, fatal MI and nonfatal MI that occurred from 30 days of study entry onwards. Results: With the exception of glycated hemoglobin (p = 0.001) and triglycerides (p = 0.04), no differences were found between groups for all other biochemical, clinical or angiographic admission characteristics. Myocardial tissue reperfusion defined as MBG 3 was observed in 62% in the ND group, 50% in the kT2DM group and 23% in the uT2DM group (p = 0.01). All-cause in-hospital mortality was higher in uT2DM (16.7%) than in kT2DM (8.4%) and both groups had a higher mortality rate as compared with the ND group (3.8%, p = 0.01). During follow-up (653 ± 26 days), the incidence of MACE was higher in uT2DM than in kT2DM and in both compared to the ND group (p = 0.002). Conclusion: Unawareness of T2DM diagnosis is strongly associated with a poor short- and long-term outcome after MI.
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pubInforma UK Ltd
pmid23927444
doi10.1185/03007995.2013.832186