Sustained prognostic implications of newly detected glucose abnormalities in patients with acute myocardial infarction: long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort

Diab Vasc Dis Res. 2015 Jan;12(1):23-32. doi: 10.1177/1479164114551746. Epub 2014 Oct 13.

Abstract

Objective: To investigate long-term prognostic importance of newly discovered glucose disturbances in patients with acute myocardial infarction (AMI).

Methods: During 1998-2001, consecutive patients with AMI (n = 167) and healthy controls (n = 184) with no previously known diabetes were investigated with an oral glucose tolerance test (OGTT). Patients and controls were separately followed up for cardiovascular events (first of cardiovascular mortality/AMI/stroke/heart failure) during a decade.

Results: In all, 68% of the patients and 35% of the controls had newly detected abnormal glucose tolerance (AGT). Cardiovascular event (n = 72, p = 0.0019) and cardiovascular mortality (n = 31, p = 0.031) were more frequent in patients with newly detected AGT. Regarding patients, a Cox proportional-hazard regression analysis identified AGT (hazard ratio (HR): 2.30; 95% confidence interval (CI): 1.24-4.25; p = 0.008) and previous AMI (HR: 2.39; CI: 1.31-4.35; p = 0.004) as prognostically important.

Conclusion: An OGTT at discharge after AMI disclosed a high proportion of patients with previously unknown AGT which had a significant and independent association with long-term prognosis.

Keywords: Myocardial infarction; diabetes; impaired glucose tolerance; oral glucose tolerance test; prognosis.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetic Cardiomyopathies / blood
  • Diabetic Cardiomyopathies / diagnosis*
  • Diabetic Cardiomyopathies / epidemiology
  • Diabetic Cardiomyopathies / mortality
  • Female
  • Follow-Up Studies
  • Glucose Intolerance / complications
  • Glucose Intolerance / diagnosis*
  • Glucose Tolerance Test
  • Humans
  • Male
  • Middle Aged
  • Mortality
  • Myocardial Infarction / complications*
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / mortality
  • Patient Discharge
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Recurrence
  • Risk Factors
  • Survival Analysis
  • Sweden / epidemiology