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Article: Sudden cardiac death after myocardial infarction in type 2 diabetic patients with no residual myocardial ischemia
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TitleSudden cardiac death after myocardial infarction in type 2 diabetic patients with no residual myocardial ischemia
 
AuthorsYeung, CY1
Lam, KSL1
Li, SW2
Lam, KF1
Tse, HF1
Siu, CW1
 
Issue Date2012
 
PublisherAmerican Diabetes Association. The Journal's web site is located at http://diabetes.diabetesjournals.org/
 
CitationDiabetes Care, 2012, v. 35 n. 12, p. 2564-2569 [How to Cite?]
DOI: http://dx.doi.org/10.2337/dc12-0118
 
AbstractOBJECTIVE Diabetes mellitus (DM) is a well-established risk factor for coronary artery disease. Nonetheless, it remains unclear whether DM contributes to sudden cardiac death in patients who survive myocardial infarction (MI). The objective of this study was to compare the incidence of sudden cardiac death post-MI in diabetic and nondiabetic patients with no residual myocardial ischemia. RESEARCH DESIGN AND METHODS A total of 610 consecutive post-MI patients referred to a cardiac rehabilitation program with negative exercise stress test were studied. RESULTS Of these, 236 patients had DM at baseline. Over a mean follow-up of 5 years, 67 patients with DM (28.4%) and 76 of 374 patients without DM (20.2%) had died with a hazard ratio (HR) of 1.74 (95% CI: 1.28-2.56; P < 0.001). Patients with DM also had a higher incidence of cardiac death (1.84 [1.16-3.21]; P = 0.01), principally due to a higher incidence of sudden cardiac death (2.14 [1.22-4.23]; P < 0.001). Multiple Cox regression analysis revealed that only DM (adjusted HR: 1.9 [95% CI: 1.04-3.40]; P = 0.04), left ventricular ejection fraction (LVEF) </=30% (3.6 [1.46-8.75]; P < 0.01), and New York Heart Association functional class >II (4.2 [1.87-9.45]; P < 0.01) were independent predictors for sudden cardiac death. Among patients with DM, the 5-year sudden cardiac death rate did not differ significantly among those with LVEF </=30%, LVEF 31-50%, or LVEF >50% (8.8 vs. 7.8 vs. 6.8%, respectively; P = 0.83). CONCLUSIONS Post-MI patients with DM, even in the absence of residual myocardial ischemia clinically, were at higher risk of sudden cardiac death than their non-DM counterparts.
 
ISSN0149-5992
2013 Impact Factor: 8.570
 
DOIhttp://dx.doi.org/10.2337/dc12-0118
 
PubMed Central IDPMC3507604
 
DC FieldValue
dc.contributor.authorYeung, CY
 
dc.contributor.authorLam, KSL
 
dc.contributor.authorLi, SW
 
dc.contributor.authorLam, KF
 
dc.contributor.authorTse, HF
 
dc.contributor.authorSiu, CW
 
dc.date.accessioned2012-09-20T07:58:01Z
 
dc.date.available2012-09-20T07:58:01Z
 
dc.date.issued2012
 
dc.description.abstractOBJECTIVE Diabetes mellitus (DM) is a well-established risk factor for coronary artery disease. Nonetheless, it remains unclear whether DM contributes to sudden cardiac death in patients who survive myocardial infarction (MI). The objective of this study was to compare the incidence of sudden cardiac death post-MI in diabetic and nondiabetic patients with no residual myocardial ischemia. RESEARCH DESIGN AND METHODS A total of 610 consecutive post-MI patients referred to a cardiac rehabilitation program with negative exercise stress test were studied. RESULTS Of these, 236 patients had DM at baseline. Over a mean follow-up of 5 years, 67 patients with DM (28.4%) and 76 of 374 patients without DM (20.2%) had died with a hazard ratio (HR) of 1.74 (95% CI: 1.28-2.56; P < 0.001). Patients with DM also had a higher incidence of cardiac death (1.84 [1.16-3.21]; P = 0.01), principally due to a higher incidence of sudden cardiac death (2.14 [1.22-4.23]; P < 0.001). Multiple Cox regression analysis revealed that only DM (adjusted HR: 1.9 [95% CI: 1.04-3.40]; P = 0.04), left ventricular ejection fraction (LVEF) </=30% (3.6 [1.46-8.75]; P < 0.01), and New York Heart Association functional class >II (4.2 [1.87-9.45]; P < 0.01) were independent predictors for sudden cardiac death. Among patients with DM, the 5-year sudden cardiac death rate did not differ significantly among those with LVEF </=30%, LVEF 31-50%, or LVEF >50% (8.8 vs. 7.8 vs. 6.8%, respectively; P = 0.83). CONCLUSIONS Post-MI patients with DM, even in the absence of residual myocardial ischemia clinically, were at higher risk of sudden cardiac death than their non-DM counterparts.
 
dc.identifier.citationDiabetes Care, 2012, v. 35 n. 12, p. 2564-2569 [How to Cite?]
DOI: http://dx.doi.org/10.2337/dc12-0118
 
dc.identifier.doihttp://dx.doi.org/10.2337/dc12-0118
 
dc.identifier.eissn1935-5548
 
dc.identifier.epage2569
 
dc.identifier.hkuros209326
 
dc.identifier.issn0149-5992
2013 Impact Factor: 8.570
 
dc.identifier.issue12
 
dc.identifier.pmcidPMC3507604
 
dc.identifier.pmid22875229
 
dc.identifier.scopuseid_2-s2.0-84869792154
 
dc.identifier.spage2564
 
dc.identifier.urihttp://hdl.handle.net/10722/164334
 
dc.identifier.volume35
 
dc.languageeng
 
dc.publisherAmerican Diabetes Association. The Journal's web site is located at http://diabetes.diabetesjournals.org/
 
dc.publisher.placeUnited States
 
dc.relation.ispartofDiabetes Care
 
dc.titleSudden cardiac death after myocardial infarction in type 2 diabetic patients with no residual myocardial ischemia
 
dc.typeArticle
 
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<item><contributor.author>Yeung, CY</contributor.author>
<contributor.author>Lam, KSL</contributor.author>
<contributor.author>Li, SW</contributor.author>
<contributor.author>Lam, KF</contributor.author>
<contributor.author>Tse, HF</contributor.author>
<contributor.author>Siu, CW</contributor.author>
<date.accessioned>2012-09-20T07:58:01Z</date.accessioned>
<date.available>2012-09-20T07:58:01Z</date.available>
<date.issued>2012</date.issued>
<identifier.citation>Diabetes Care, 2012, v. 35 n. 12, p. 2564-2569</identifier.citation>
<identifier.issn>0149-5992</identifier.issn>
<identifier.uri>http://hdl.handle.net/10722/164334</identifier.uri>
<description.abstract>OBJECTIVE Diabetes mellitus (DM) is a well-established risk factor for coronary artery disease. Nonetheless, it remains unclear whether DM contributes to sudden cardiac death in patients who survive myocardial infarction (MI). The objective of this study was to compare the incidence of sudden cardiac death post-MI in diabetic and nondiabetic patients with no residual myocardial ischemia. RESEARCH DESIGN AND METHODS A total of 610 consecutive post-MI patients referred to a cardiac rehabilitation program with negative exercise stress test were studied. RESULTS Of these, 236 patients had DM at baseline. Over a mean follow-up of 5 years, 67 patients with DM (28.4%) and 76 of 374 patients without DM (20.2%) had died with a hazard ratio (HR) of 1.74 (95% CI: 1.28-2.56; P &lt; 0.001). Patients with DM also had a higher incidence of cardiac death (1.84 [1.16-3.21]; P = 0.01), principally due to a higher incidence of sudden cardiac death (2.14 [1.22-4.23]; P &lt; 0.001). Multiple Cox regression analysis revealed that only DM (adjusted HR: 1.9 [95% CI: 1.04-3.40]; P = 0.04), left ventricular ejection fraction (LVEF) &lt;/=30% (3.6 [1.46-8.75]; P &lt; 0.01), and New York Heart Association functional class &gt;II (4.2 [1.87-9.45]; P &lt; 0.01) were independent predictors for sudden cardiac death. Among patients with DM, the 5-year sudden cardiac death rate did not differ significantly among those with LVEF &lt;/=30%, LVEF 31-50%, or LVEF &gt;50% (8.8 vs. 7.8 vs. 6.8%, respectively; P = 0.83). CONCLUSIONS Post-MI patients with DM, even in the absence of residual myocardial ischemia clinically, were at higher risk of sudden cardiac death than their non-DM counterparts.</description.abstract>
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<publisher>American Diabetes Association. The Journal&apos;s web site is located at http://diabetes.diabetesjournals.org/</publisher>
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Author Affiliations
  1. The University of Hong Kong
  2. Tung Wah Hospital