Impact of diabetes on mortality in patients with myocardial infarction and left ventricular dysfunction
Impact of diabetes on mortality in patients with myocardial infarction and left ventricular dysfunction
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DOI：
10.1001/archinte.164.20.2273
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发表时间：
2004-11-08
影响因子：
--
通讯作者：
Pfeffer, MA
中科院分区：
文献类型：
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作者：
Murcia, AM;Hennekens, CH;Pfeffer, MA
背景：糖尿病是冠心病的主要危险因素。在心肌梗死（MI）后存活的糖尿病患者中，对随后的发病率和死亡率知之甚少。我们评估了糖尿病在心肌梗死后左心室功能不全患者心血管事件和death.Methods的影响：生存和心室Entrance，随机，双盲，安慰剂对照的多中心试验，评价了2231例急性心肌梗死后左心室功能不全定义为射血分数小于或等于40%的有效性，卡托普利与安慰剂。患者被随机分配到卡托普利或安慰剂3至16天后MI，并随访2至5年（平均，3.5年）。结果：在2231，496（22.2%）的患者有糖尿病史，其中168（33.9%）与胰岛素治疗。糖尿病患者年龄明显较大;更可能是女性;有既往MI或高血压史;肥胖或明显Killip II级或更高;收缩压、脉压和心率较高，射血分数较低。随访期间，糖尿病患者死亡率为31.3%，非糖尿病患者死亡率为20.1%（P
Background: Diabetes is a major risk factor for developing coronary heart disease. In patients with diabetes who survived myocardial infarction (MI), less is known about subsequent morbidity and mortality. We evaluated the effects of diabetes in post-MI patients with left ventricular dysfunction on cardiovascular events and death.Methods: The Survival and Ventricular Enlargement, a randomized, double-blind, placebo-controlled multicenter trial, evaluated the efficacy of captopril vs placebo in 2231 patients following acute MI with left ventricular dysfunction defined as an ejection fraction less than or equal to 40%. Patients were randomly assigned to captopril or placebo 3 to 16 clays following MI and were followed up for 2 to 5 years (mean, 3.5 years).Results: Among the 2231, 496 (22.2%) were patients with a history of diabetes, of which 168 (33.9%) were treated with insulin. Patients with diabetes were significantly older; more likely to be women; have a history of prior MI or hypertension; be obese or manifest Killip class II or greater; and have higher systolic blood pressure, pulse pressure, and heart rate, as well as lower ejection fraction. During followup, 31.3% of patients with diabetes and 20.1% of nondiabetic patients died (P