■急性心肌梗死(AMI)后2型糖尿病(T2DM)的长期影响尚未得到彻底研究。本研究旨在评估AMI后T2DM的长期影响。
■我们分析了法国急性ST段抬高和非ST段抬高心肌梗死(FAST-MI)注册计划的三项全国性观察性研究的数据,在2005年,2010年和2015年进行了1个月的时间。2型糖尿病患者被归类为糖尿病患者,并排除1型糖尿病患者.我们确定了1年随访时与全因死亡相关的因素,并将1,897名受试者分为两组,根据逻辑回归模型确定的估计1年死亡概率配对。
■共有9,181名AMI患者被纳入分析,其中2,038人(22.2%)患有T2DM。糖尿病患者明显年龄较大(68.2±12.0vs.63.8±14.4,p<0.001),并且有较高的经皮冠状动脉介入治疗(PCI)病史,冠状动脉旁路移植术(CABG),或心力衰竭(22.5%vs.13.0%,7.1%与3.1%和6.7%vs.分别为3.8%,全部p<0.001)。即使在根据1年死亡概率的倾向评分匹配两组1,897名患者之后,糖尿病仍然与长期死亡率相关,HR为1.30,95CI(1.17-1.45),p<0.001。
■T2DM本身对心肌梗死后的长期生存有不利影响。与短期死亡的风险无关,存活于AMI的糖尿病患者的长期死亡风险高30%.
UNASSIGNED: The long-term impact of type 2 diabetes mellitus (T2DM) after an acute myocardial infarction (AMI) has not been thoroughly investigated yet. This study aimed to assess the long-term impact of T2DM after AMI.
UNASSIGNED: We analyzed the data of three nationwide observational studies from the French Registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) program, conducted over a 1-month period in 2005, 2010, and 2015. Patients presenting T2DM were classified as diabetic, and patients presenting type 1 diabetes mellitus were excluded. We identified factors related to all-cause death at 1-year follow-up and divided 1,897 subjects into two groups, paired based on their estimated 1-year probability of death as determined by a logistic regression model.
UNASSIGNED: A total of 9,181 AMI patients were included in the analysis, among them 2,038 (22.2%) had T2DM. Patients with diabetes were significantly older (68.2 ± 12.0 vs. 63.8 ± 14.4, p < 0.001) and had a higher prevalence of a prior history of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), or heart failure (22.5% vs. 13.0%, 7.1% vs. 3.1% and 6.7 vs. 3.8% respectively, p < 0.001 for all). Even after matching two groups of 1,897 patients based on propensity score for their 1-year probability of death, diabetes remained associated with long-term mortality, with an HR of 1.30, 95%CI (1.17-1.45), p < 0.001.
UNASSIGNED: T2DM per se has an adverse impact on long-term survival after myocardial infarction. Independently of the risk of short-term mortality, patients with diabetes who survived an AMI have a 30% higher risk of long-term mortality.