Literature DB >> 30274618

Type 2 diabetes and coronary artery disease: Preserved ejection fraction and sudden cardiac death.

M Juhani Junttila1, Antti M Kiviniemi2, E Samuli Lepojärvi2, Mikko Tulppo2, Olli-Pekka Piira2, Tuomas Kenttä2, Juha S Perkiömäki2, Olavi H Ukkola2, Robert J Myerburg3, Heikki V Huikuri2.   

Abstract

BACKGROUND: Previous studies have shown that type 2 diabetes (DM2) is associated with sudden cardiac death (SCD) risk in post-myocardial infarction patients. The treatment of coronary artery disease (CAD) as well as DM2 has changed over time.
OBJECTIVE: The purpose of this study was to compare the incidence of SCD in DM2 and nondiabetic patients with CAD and preserved ejection fraction (EF) in a prospective observational study (ARTEMIS study).
METHODS: In 834 DM2 patients and 1112 nondiabetic patients with CAD enrolled, the EF measured ≥3 months after qualifying was 63% ± 10% in DM2 patients and 65% ± 8% in nondiabetic patients (P < .01). The primary end point was SCD or resuscitation from sudden cardiac arrest (SCA). All-cause mortality, cardiac mortality, non-SCD, hospitalization for heart failure, and acute coronary syndrome were secondary end points.
RESULTS: During a mean follow-up of 6.3 ± 1.6 years, SCDs/SCAs occurred in 50 patients. The prevalence of SCD/SCA was higher in DM2 patients (4.1%) than in nondiabetic patients (1.4%) (adjusted hazard ratio 2.6; 95% confidence interval 1.3-5.3; P < .01). However, the non-SCD component of cardiac mortality was not significantly different between DM2 and nondiabetic patients. In addition, heart failure hospitalizations were more common in DM2 patients (8.4%) than in nondiabetic patients (2.9%) (P < .001). The annual cardiac mortality in nondiabetic patients with CAD was 0.50%, which was lower than the 0.59% reported in the general Finnish population.
CONCLUSION: DM2 is an independent risk factor for SCD/SCA in CAD patients with preserved EF. Cardiac mortality in nondiabetic CAD patients is slightly lower than that in the general population in the present treatment era.
Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Cardiac death; Coronary artery disease; Outcome; Sudden cardiac death; Type 2 diabetes

Mesh:

Year:  2018        PMID: 30274618     DOI: 10.1016/j.hrthm.2018.06.017

Source DB:  PubMed          Journal:  Heart Rhythm        ISSN: 1547-5271            Impact factor:   6.343


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