Risk factors for myocardial infarction case fatality and stroke case fatality in type 2 diabetes
Risk factors for myocardial infarction case fatality and stroke case fatality in type 2 diabetes
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DOI：
10.2337/diacare.27.1.201
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发表时间：
2004-01-01
期刊：
影响因子：
16.2
通讯作者：
Holman, RR
中科院分区：
文献类型：
--
作者：
Stevens, R;Coleman, RL;Holman, RR
目的：糖尿病患者心肌梗死（MI）或卒中的病死率高于非糖尿病患者：即，如果存在糖尿病，MI和卒中往往是致命的。我们调查了是否可以使用糖尿病诊断时的可用信息来估计2型糖尿病患者心肌梗死或卒中的致命风险。研究设计和方法-分析基于674例MI（351例死亡），发生在5,102名英国人中的597名。前瞻性糖尿病研究（UKPDS）患者，其协变量数据在中位随访7年期间可用。采用多变量逻辑回归分析在糖尿病诊断后2年内测量的致死性和非致死性MI之间的危险因素差异。对199例患者中发生的234例卒中（48例致死性）进行了类似的分析。结果-致死性MI患者的HbA（1c）高于非致死性MI患者（比值比为1.17/1%HbA（1c），P = 0.014）。致死性卒中患者的HbA（1c）高于非致死性卒中患者（比值比为1.37/1%HbA（1c），P = 0.007）。MI病死率的其他危险因素包括年龄增加，血压，尿白蛋白level.CONCLUSIONS -MI或中风的风险是致命的2型糖尿病与危险因素，包括HbA（1c），测量MI或中风发作前多年。UKPDS风险引擎中添加了公式，以估计MI和卒中的可能病死率。
OBJECTIVE - Patients with diabetes have a higher case fatality rate in myocardial infarction (Ml) or stroke than those without diabetes: that is, MI and stroke are more often fatal if diabetes is present. We investigated whether the risk of MI Or Stroke being fatal in type 2 diabetes can be estimated using information available around the time diabetes is diagnosed. RESEARCHDESIGN AND METHODS - Analyses were based on 674 cases of MI (351 fatal) that occurred in 597 of 5,102 U.K. Prospective Diabetes Study (UKPDS) patients for whom covariate data were available during a median follow-up of 7 years. Multivariate logistic regression was used to examine differences in risk factors, measured within 2 years of diagnosis of diabetes, between fatal and nonfatal MI. Similar analyses were performed for 234 strokes (48 fatal) that occurred in 199 patients.RESULTS - Patients with Fatal MI had higher HbA(1c) than those With nonfatal MI (odds ratio 1.17 per 1% HbA(1c), P = 0.014). Patients with fatal stroke had higher HbA(1c) than those with nonfatal stroke (odds ratio 1.37 per 1% HbA(1c), P = 0.007). Other risk factors for MI case fatality included increased age, blood pressure, and urine albumin level.CONCLUSIONS - The risk of MI or stroke being fatal in type 2 diabetes is associated with risk factors, including HbA(1c), measured many years before onset of MI or stroke. Equations have been added to the UKPDS Risk Engine to estimate likely case fatality rates in MI and Stroke.