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
2011 Impact Factor: 8.087
2011 SCImago Journal Rankings: 0.776
DOIhttp://dx.doi.org/10.2337/dc12-0118
PubMed Central IDPMC3507604
DC Field
Value
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.epage2569
dc.identifier.hkuros209326
dc.identifier.issn0149-5992
2011 Impact Factor: 8.087
2011 SCImago Journal Rankings: 0.776
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
Author Affiliations
  1. The University of Hong Kong
  2. Tung Wah Hospital