BACKGROUND: Type 2 diabetes mellitus is a well-established risk factor for atherosclerosis, but its contribution to sudden cardiac death (SCD) risk after myocardial infarction (MI) is not well defined. OBJECTIVE: The purpose of this study was to compare the incidence and time-dependent risk of SCD in diabetic patients versus nondiabetic patients during 5-year follow-up after acute MI. METHODS: A total of 3,276 patients were enrolled at the time of acute MI between 1996 and 2005. Mean age at entry was 60 ± 11 years, and the cohort was followed until 2009. At entry into the study, diabetes was present in 629 (19.2%) patients. The primary endpoint was SCD, and the secondary endpoints were non-SCD and all-cause mortality. RESULTS: Among diabetic patients, the incidence of SCD was higher (5.9%) than in nondiabetic patients (1.7%), with a hazard ratio (HR) of 3.8 (95% confidence interval [CI] 2.4-5.8; P <.001) and adjusted HR of 2.3 (95% CI 1.4-3.8; P <.01). In diabetic patients with left ventricular ejection fraction >35%, the incidence of SCD was nearly identical to that of nondiabetic patients with ventricular ejection fraction ≤35% (4.1% vs 4.9%; P = .48). An excess in the incidence of non-SCD began to appear among diabetic patients within the first 6 months of follow-up (P <.001) but not in the incidence of SCD (P = .09). The excess in SCD among diabetic patients began to appear more than 6 months after the index event. CONCLUSION: Patients with type 2 diabetes are at higher risk for SCD after MI than are nondiabetic patients. The incidence of SCD in post-MI type 2 diabetic patients with left ventricular ejection fraction >35% is equal to that of nondiabetic patients with left ventricular ejection fraction <35%.
BACKGROUND: Type 2 diabetes mellitus is a well-established risk factor for atherosclerosis, but its contribution to sudden cardiac death (SCD) risk after myocardial infarction (MI) is not well defined. OBJECTIVE: The purpose of this study was to compare the incidence and time-dependent risk of SCD in diabeticpatients versus nondiabeticpatients during 5-year follow-up after acute MI. METHODS: A total of 3,276 patients were enrolled at the time of acute MI between 1996 and 2005. Mean age at entry was 60 ± 11 years, and the cohort was followed until 2009. At entry into the study, diabetes was present in 629 (19.2%) patients. The primary endpoint was SCD, and the secondary endpoints were non-SCD and all-cause mortality. RESULTS: Among diabeticpatients, the incidence of SCD was higher (5.9%) than in nondiabeticpatients (1.7%), with a hazard ratio (HR) of 3.8 (95% confidence interval [CI] 2.4-5.8; P <.001) and adjusted HR of 2.3 (95% CI 1.4-3.8; P <.01). In diabeticpatients with left ventricular ejection fraction >35%, the incidence of SCD was nearly identical to that of nondiabeticpatients with ventricular ejection fraction ≤35% (4.1% vs 4.9%; P = .48). An excess in the incidence of non-SCD began to appear among diabeticpatients within the first 6 months of follow-up (P <.001) but not in the incidence of SCD (P = .09). The excess in SCD among diabeticpatients began to appear more than 6 months after the index event. CONCLUSION:Patients with type 2 diabetes are at higher risk for SCD after MI than are nondiabeticpatients. The incidence of SCD in post-MI type 2 diabeticpatients with left ventricular ejection fraction >35% is equal to that of nondiabeticpatients with left ventricular ejection fraction <35%.
Authors: Juha Perkiömäki; Derek V Exner; Olli-Pekka Piira; Katherine Kavanagh; Samuli Lepojärvi; Mario Talajic; Jarkko Karvonen; Francois Philippon; Juhani Junttila; Benoit Coutu; Heikki Huikuri Journal: Ann Noninvasive Electrocardiol Date: 2015-01-15 Impact factor: 1.468
Authors: Ravi B Patel; M V Moorthy; Stephanie E Chiuve; Aruna D Pradhan; Nancy R Cook; Christine M Albert Journal: Heart Rhythm Date: 2016-08-31 Impact factor: 6.343
Authors: Michael J Cutler; Bradley N Plummer; Xiaoping Wan; Qi-An Sun; Douglas Hess; Haiyan Liu; Isabelle Deschenes; David S Rosenbaum; Jonathan S Stamler; Kenneth R Laurita Journal: Proc Natl Acad Sci U S A Date: 2012-10-15 Impact factor: 11.205