Influence of impaired glucose tolerance on long-term survival after acute myocardial infarction
Influence of impaired glucose tolerance on long-term survival after acute myocardial infarction
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DOI：
10.1055/s-2002-31529
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发表时间：
2002-05-24
影响因子：
0.6
通讯作者：
Nauck, MA
中科院分区：
文献类型：
--
作者：
Meier, JJ;Deifuss, S;Nauck, MA
背景与目的：糖耐量异常和2型糖尿病与心血管死亡率增加相关。本研究旨在确定急性心肌梗死（AMI）与糖耐量受损的直接时间关系是否也是如此。（女性232人，男性330人;年龄68 +/-13岁），诊断为AMI，在超过3年的时间内进行了前瞻性评估。2型糖尿病以前已知有152例，而新诊断的有83例。结果：129例患者中，60例（47%）OGTT正常，45例（35%）糖耐量减低，24例（19%）既往未诊断糖尿病（WHO标准）。所有2型糖尿病患者的生存率明显低于其余患者（p < 0.0001）。糖耐量受损患者的生存时间明显短于糖耐量正常患者（p = 0.029）。即使排除那些在急性梗死后阶段死亡的患者，正常和糖耐量受损的患者之间的差异仍然显着（p = 0.034）。结论：糖耐量受损的患者有一个显着较短的生存期后AMI比那些正常的糖耐量。因此，口服葡萄糖摄入后2小时的血糖浓度似乎是AMI后死亡的重要预测因素。
Background and objective: An impaired glucose tolerance as well as type 2 diabetes are associated with an increased cardiovascular mortality. This study was undertaken to determine whether this is also true for impaired glucose tolerance in immediate temporal relation with an acute myocardial infarction (AMI).Patients and methods: The survival of 562 patients (232 females, 330 males; age 68 +/- 13 years) consecutively admitted to the intensive care unit of a medical department with the diagnosis of AMI, were prospectively evaluated over a span of more than 3 years. Type 2 diabetes had been previously known in 152, while it was newly diagnosed in 83 patients. Oral glucose tolerance tests (OGTT) were performed in 129, but the test was not performed in 222 patients, Survival was analysed with the Kaplan-Meier test.Results: Among the 129 patients who had had an OGTT, it was normal in 60 (47%), 45 (35%) had impaired glucose tolerance and 24 (19%) were found to have previously undiagnosed diabetes (WHO criteria). Survival of all patients with type 2-diabetes was significantly worse than in the remainder of patients (p < 0.0001). In patients with impaired glucose tolerance the survival time was significantly shorter than in those with normal glucose tolerance (p = 0.029). Even after excluding those patients who had died in the acute post-infarction phase, the difference between patients with normal and with impaired glucose tolerance remained significant (p = 0.034).Conclusion: Patients with impaired glucose tolerance have a significantly shorter survival after AMI than those with a normal glucose tolerance. Blood glucose concentration 2 hours after oral glucose intake thus seems to be an important predictor of death after AMI.