Diabetes mellitus is a strong negative prognostic factor in patients with myocardial infarction treated with thrombolytic therapy.

Abstract:

OBJECTIVES:To assess the long-term prognostic values of baseline demographic data, occurrence of vectorcardiographic signs of reperfusion, left ventricular function and coronary angiographic features. DESIGN:Longitudinal study of morbidity and mortality. SETTING:Coronary care unit at Danderyd Hospital, Stockholm, Sweden. SUBJECTS:A total of 222 patients (mean age 61 years) with a suspected acute myocardial infarction treated with thrombolysis were investigated and followed for 2-5 years (mean 1216 days). MAIN OUTCOME MEASURES:Death or a new myocardial infarction. RESULTS:Age above 55 years (P < 0.05), a previous diagnosis of diabetes mellitus (P < 0.005), hypertension (P < 0.05), heart failure (P < 0.001) and myocardial infarction (P < 0.05), a previous use of beta-blockers (P < 0.05) and an ejection fraction below 60% (P < 0.01) were predictors for death or a new myocardial infarction in univariate analysis. Sex, a previous history of smoking or angina pectoris, vectorcardiographic signs of reperfusion or degree of coronary artery disease had no prognostic values. In multivariate analysis including age above 55 years, a previous diagnosis of diabetes mellitus, hypertension and myocardial infarction, and an ejection fraction below 60%, only age (P < 0.05), diabetes mellitus (P < 0. 01) and ejection fraction (P < 0.05) were predictors for death or a new myocardial infarction. CONCLUSIONS:The results of the present study emphasize the importance of diabetes mellitus as a long-term prognostic risk factor in patients with myocardial infarction treated with thrombolysis. Further studies are needed to determine the mechanisms behind this increased risk.

journal_name

J Intern Med

authors

Strandberg LE,Ericsson CG,O'Konor ML,Bergstrand L,Lundin P,Rehnqvist N,Tornvall P

doi

10.1046/j.1365-2796.2000.00007.x

subject

Has Abstract

pub_date

2000-08-01 00:00:00

pages

119-25

issue

2

eissn

0954-6820

issn

1365-2796

pii

jm707

journal_volume

248

pub_type

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