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Impaired glucose tolerance or newly diagnosed diabetes mellitus diagnosed during admission adversely affects prognosis after myocardial infarction: An observational study

George, Anish; Bhatia, Raghav T.; Buchanan, Gill L.; Whiteside, Anne; Moisey, Robert S.; Beer, Stephen F.; Chattopadhyay, Sudipta; Sathyapalan, Thozhukat; John, Joseph

Authors

Anish George

Raghav T. Bhatia

Gill L. Buchanan

Anne Whiteside

Robert S. Moisey

Stephen F. Beer

Sudipta Chattopadhyay

Thozhukat Sathyapalan

Joseph John



Contributors

Yoshiaki Taniyama
Editor

Abstract

Objective To investigate the prognostic effect of newly diagnosed diabetes mellitus (NDM) and impaired glucose tolerance (IGT) post myocardial infarction (MI). Research Design and Methods Retrospective cohort study of 768 patients without preexisting diabetes mellitus post-MI at one centre in Yorkshire between November 2005 and October 2008. Patients were categorised as normal glucose tolerance (NGT n = 337), IGT (n = 279) and NDM (n = 152) on predischarge oral glucose tolerance test (OGTT). Primary end-point was the first occurrence of major adverse cardiovascular events (MACE) including cardiovascular death, non-fatal MI, severe heart failure (HF) or non-haemorrhagic stroke. Secondary end-points were all cause mortality and individual components of MACE. Results Prevalence of NGT, impaired fasting glucose (IFG), IGT and NDM changed from 90%, 6%, 0% and 4% on fasting plasma glucose (FPG) to 43%, 1%, 36% and 20% respectively after OGTT. 102 deaths from all causes (79 as first events of which 46 were cardiovascular), 95 non fatal MI, 18 HF and 9 non haemorrhagic strokes occurred during 47.2 ± 9.4 months follow up. Event free survival was lower in IGT and NDM groups. IGT (HR 1.54, 95% CI: 1.06–2.24, p = 0.024) and NDM (HR 2.15, 95% CI: 1.42–3.24, p = 0.003) independently predicted MACE free survival. IGT and NDM also independently predicted incidence of MACE. NDM but not IGT increased the risk of secondary end-points. Conclusion Presence of IGT and NDM in patients presenting post-MI, identified using OGTT, is associated with increased incidence of MACE and is associated with adverse outcomes despite adequate secondary prevention.

Journal Article Type Article
Publication Date Oct 16, 2015
Journal PLoS one
Print ISSN 1932-6203
Electronic ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 10
Issue 11
Article Number ARTN e0142045
Pages e0142045
Institution Citation George, A., Bhatia, R. T., Buchanan, G. L., Whiteside, A., Moisey, R. S., Beer, S. F., …John, J. (2015). Impaired glucose tolerance or newly diagnosed diabetes mellitus diagnosed during admission adversely affects prognosis after myocardial infarction: An observational study. PloS one, 10(11), e0142045. doi:10.1371/journal.pone.0142045
DOI https://doi.org/10.1371/journal.pone.0142045
Keywords Impaired glucose intolerance
Publisher URL http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0142045
Copyright Statement © 2015 George et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Additional Information This is an open access article published in Plos one 2015, v.10 issue 11.

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Copyright Statement
© 2015 George et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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