Diabetes is an independent predictor of survival 17 years after myocardial infarction: follow-up of the TRACE registry

[摘要] BackgroundIn patients hospitalized for myocardial infarction, there are limited data examining the long-term prognostic effect of diabetes.The aim of this study was to systematically evaluate the development of diabetes as an independent long-term prognostic factor after myocardial infarction.MethodsProspective follow-up of 6676 consecutive MI patients screened for entry in the Trandolapril Cardiac Evaluation (TRACE) study. The patients were analysed by Kaplan-Meier survival analysis, landmark analysis and Cox proportional hazard models and outcome measure was all-cause mortality.ResultsThe mortality in patients with diabetes was 82,7% at 10 years of follow-up and 91,1% at 15 years of follow-up, while patients without diabetes had a mortality of 60,2% at 10 years of follow-up and 72,9% at 15 years of follow-up (p < 0.0001). Landmark analysis continued to show prognostic significance of diabetes throughout the duration of follow-up. Multivariable Cox proportional-hazards model showed that the hazard ratio for death in patients with diabetes overall was 1.47 (95% confidence intervals (CI) 1.35-1.61) and varied between 1.19 (CI 1.04-1.37) and 2.13 (CI 1.33-3.42) in the 2-year periods of follow-up.ConclusionsDiabetes is an important independent long-term prognostic factor after MI and continues to predict mortality even 17 years after index MI.This underscores the importance of aggressive diagnostic and therapeutic approach in diabetes patients with MI.

[发布日期] 2010-06-02

[关键词] Eplerenone;Trace Study;Trandolapril;Abnormal Glucose Tolerance;Landmark Analysis