侵入性治疗时代糖尿病患者急性心肌梗死的短期和长期预后

Short and long-term outcome in diabetic patients with acute myocardial infarction in the invasive era.

作者信息

Hansen Hans-Henrik T, Joensen Albert M, Riahi Sam, Malczynski Jerzy, Mølenberg David, Ravkilde Jan

机构信息

Department of Cardiology, Cardiovascular Research Center, Aalborg Hospital, Aarhus University Hospital, Denmark.

出版信息

Scand Cardiovasc J. 2007 Jan;41(1):19-24. doi: 10.1080/14017430601099238.

DOI:10.1080/14017430601099238

PMID:17365973

Abstract

OBJECTIVES

To investigate the outcome after acute myocardial infarction in diabetic patients compared with non-diabetic patients in a period with invasive treatment as the preferred treatment for acute myocardial infarction (MI).

DESIGN

Patient records for all patients admitted with an acute MI in a two-year period from July 1, 2001 to June 30, 2003 were reviewed.

RESULTS

A total of 334 patients entered the study: 48 with diabetes mellitus (DM) and 286 without diabetes. ST-elevation infarction occurred in 49% of non-diabetic patients and 36% of diabetic patients. In-hospital mortality was 23% among diabetic patients compared to 5% among non-diabetic patients (p < 0.001). Long-term mortality (median 2 years and 10 months) was 44% in diabetic-patients and 23% in non-diabetic patients (p = 0.001). Diabetic patients were older, more frequently had hypertension and three-vessel disease, but DM was found to be an independent risk factor for death after MI (p = 0.005).

CONCLUSIONS

In an era of invasive therapy as the preferred therapy for acute MI, DM is still associated with considerably increased mortality after an acute MI.

摘要

目的

在以侵入性治疗作为急性心肌梗死（MI）首选治疗方法的时期，研究糖尿病患者与非糖尿病患者急性心肌梗死后的结局。

设计

回顾了2001年7月1日至2003年6月30日这两年期间所有因急性心肌梗死入院患者的病历。

结果

共有334名患者进入研究：48名患有糖尿病（DM），286名无糖尿病。非糖尿病患者中49%发生ST段抬高型梗死，糖尿病患者中为36%。糖尿病患者的院内死亡率为23%，而非糖尿病患者为5%（p<0.001）。糖尿病患者的长期死亡率（中位时间为2年零10个月）为44%，非糖尿病患者为23%（p = 0.001）。糖尿病患者年龄更大，更常患有高血压和三支血管病变，但糖尿病被发现是心肌梗死后死亡的独立危险因素（p = 0.005）。