Determinants of 1-year mortality after acute myocardial infarction in patients with and without diabetes.

IF 3.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Clinical Medicine Pub Date : 2024-07-01 Epub Date: 2024-06-12 DOI:10.1016/j.clinme.2024.100223
Annalisa Montebello, Martina Agius, Martina Grech, Nicoletta Maniscalco, Ivana Kenkovski, Stephen Fava
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Abstract

The gap in excess mortality between patients with and without diabetes has not decreased over time. The aim of this study was to investigate the determinants of mortality after acute myocardial infarction (AMI) in patients with diabetes and without diabetes in a contemporary population. A retrospective analysis of a cohort of 266 patients with a diagnosis of AMI during 2022 was carried out. Patients living with diabetes had higher 1-year mortality, even after adjustment for covariates. Estimated glomerular filtration (eGFR) rate was independently associated with increased mortality in patients with diabetes. Plasma glucose was independently associated with peak troponin in patients both with and without diabetes. These data suggest that patients living with diabetes and with a low eGFR warrant more aggressive risk reduction and use of nephroprotective medications. Further studies are needed to assess whether early blood glucose control improves cardiovascular outcomes in all patients with AMI.

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糖尿病患者和非糖尿病患者急性心肌梗死后 1 年死亡率的决定因素。
随着时间的推移,糖尿病患者与非糖尿病患者之间超额死亡率的差距并未缩小。本研究旨在调查当代人群中糖尿病患者和非糖尿病患者急性心肌梗死(AMI)后死亡率的决定因素。研究对 2022 年期间确诊为急性心肌梗死的 266 名患者进行了回顾性分析。即使调整了共同变量,糖尿病患者的1年死亡率也较高。估计肾小球滤过率(eGFR)与糖尿病患者的死亡率升高密切相关。在糖尿病患者和非糖尿病患者中,血浆葡萄糖与肌钙蛋白峰值均有独立关联。这些数据表明,eGFR 低的糖尿病患者需要更积极地降低风险和使用肾脏保护药物。还需要进一步的研究来评估早期血糖控制是否能改善所有急性心肌梗死患者的心血管预后。
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来源期刊
Clinical Medicine
Clinical Medicine 医学-医学:内科
CiteScore
7.20
自引率
0.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: Clinical Medicine is aimed at practising physicians in the UK and overseas and has relevance to all those managing or working within the healthcare sector. Available in print and online, the journal seeks to encourage high standards of medical care by promoting good clinical practice through original research, review and comment. The journal also includes a dedicated continuing medical education (CME) section in each issue. This presents the latest advances in a chosen specialty, with self-assessment questions at the end of each topic enabling CPD accreditation to be acquired. ISSN: 1470-2118 E-ISSN: 1473-4893 Frequency: 6 issues per year
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