INCREASED CONGESTIVE HEART-FAILURE AFTER MYOCARDIAL-INFARCTION OF MODEST EXTENT IN PATIENTS WITH DIABETES-MELLITUS
INCREASED CONGESTIVE HEART-FAILURE AFTER MYOCARDIAL-INFARCTION OF MODEST EXTENT IN PATIENTS WITH DIABETES-MELLITUS
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DOI：
10.1016/0002-8703(84)90541-6
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发表时间：
1984-01-01
影响因子：
4.8
通讯作者：
SOBEL, BE
中科院分区：
文献类型：
--
作者：
JAFFE, AS;SPADARO, JJ;SOBEL, BE
为了阐明糖尿病患者急性心肌梗死（AMI）后生存率降低的相关因素，前瞻性评估了100例有明确记录的糖尿病患者和426例对照患者。描述和分析脑梗死的大小，并分析充血性心力衰竭（CHF）的发生率和严重程度以及随后的死亡与梗死面积的关系。与非糖尿病患者相比，糖尿病患者的指数梗死范围较小，为16.2 ± 0.2mm。2.2 CK[肌酐激酶]-gm-eq/m2与19.2 . ±-相比。0.9（P < 0.02）。然而，CHF在糖尿病患者中更常见（糖尿病患者的31.2%与15.7%）。这种差异在有持续既往梗死的糖尿病患者中最为显著（50%对16%），但在有初始梗死的糖尿病患者中也很明显（26%对16%）。糖尿病组病死率明显高于对照组（P < 0.04）。当糖尿病患者和非糖尿病患者根据是否存在CHF进行分层时，生存曲线相当。尽管梗死面积较小，但CHF的发病率增加，这表明其他因素必须有助于心肌功能障碍和由此导致的死亡率过高。
To elucidate the factors involved in the reduced survival rate of diabetic patients after acute myocardial infarction (AMI), 100 patients with well-documented diabetes and 426 control patients were prospectively evaluated. Infarct size was characterized and analyzed the incidence and severity of congestive heart failure (CHF) and subsequent death were analyzed with respect to infarct size. The extent of the index infarct was less in diabetic compared to nondiabetic patients, 16.2 .+-. 2.2 CK[creatinine kinase]-gm-eq/m2 compared with 19.2 .+-. 0.9 (P < 0.02). However, CHF was more prevalent in diabetic patients (31.2% of the diabetic patients compared to 15.7%). The difference was most prominent in diabetic patients who had sustained prior infarction (50% compared to 16%), but was evident also in diabetic patients with initial infarction (26 compared to 16%). The mortality rate was greater in diabetic patients (P < 0.04). When diabetic and nondiabetic patients were stratified with respect to the presence or absence of CHF, survival curves were comparable. The increased incidence of CHF despite a smaller infarct size suggests that additional factors must contribute to myocardial dysfunction and the resultant excess in mortality.