Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization

Hur, Seung Ho; Won, Ki‐Bum; Kim, In Cheol; Bae, Jang Ho; Choi, Dong Ju; Ahn, Young Keun; Park, Jong Seon; Kim, Hyo Soo; Choi, Rak Kyeong; Choi, Donghoon; Kim, Joon Hong; Han, Kyoo Rok; Park, Hun Sik; Choi, So Yeon; Yoon, Jung Han; Gwon, Hyeon Cheol; Rha, Seung Woon; Jang, Wooyeong; Bae, Jang Whan; Hwang, Kyung Kuk; Lim, Do Sun; Jung, Kyung Tae; Oh, Seok Kyu; Lee, Jae‐Hwan; Shin, Eun Seok; Kim, Kee Sik

doi:10.1097/md.0000000000003882

Cited by 10 publications

(6 citation statements)

References 45 publications

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“…Type 2 diabetes (T2D) is an increasingly prevalent metabolic disorder that causes serious micro- and macrovascular complications 1 . In Korea, the prevalence of diabetes and its accompanying cardiovascular disease burden have continuously increased as dietary habits become more westernized 2 , 3 . Therefore, identifying novel risk factors of T2D along with well-known factors such as insulin resistance or insufficient insulin secretion is important because proper screening can lower or delay T2D development.…”

Section: Introductionmentioning

confidence: 99%

Serum metabolite profile associated with incident type 2 diabetes in Koreans: findings from the Korean Genome and Epidemiology Study

Yang

Kwak

Jo³

et al. 2018

Sci Rep

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The identification of metabolic alterations in type 2 diabetes (T2D) is useful for elucidating the pathophysiology of the disease and in classifying high-risk individuals. In this study, we prospectively examined the associations between serum metabolites and T2D risk in a Korean community-based cohort (the Ansan–Ansung cohort). Data were obtained from 1,939 participants with available metabolic profiles and without diabetes, cardiovascular disease, or cancer at baseline. The acylcarnitine, amino acid, amine, and phospholipid levels in fasting serum samples were analyzed by targeted metabolomics. During the 8-year follow-up period, we identified 282 cases of incident T2D. Of all metabolites measured, 22 were significantly associated with T2D risk. Specifically, serum levels of alanine, arginine, isoleucine, proline, tyrosine, valine, hexose and five phosphatidylcholine diacyls were positively associated with T2D risk, whereas lyso-phosphatidylcholine acyl C17:0 and C18:2 and other glycerophospholipids were negatively associated with T2D risk. The associated metabolites were further correlated with T2D-relevant risk factors such as insulin resistance and triglyceride indices. In addition, a healthier diet (as measured by the modified recommended food score) was independently associated with T2D risk. Alterations of metabolites such as amino acids and choline-containing phospholipids appear to be associated with T2D risk in Korean adults.

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Section: Introductionmentioning

confidence: 99%

Serum metabolite profile associated with incident type 2 diabetes in Koreans: findings from the Korean Genome and Epidemiology Study

Yang

Kwak

Jo³

et al. 2018

Sci Rep

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“…1 The rate of major adverse cardiovascular events (MACE) is substantially higher in people with T2D compared with those without T2D (8.2% vs. 4.2%). 2 Cardiovascular disease (CVD) is the major cause of death in patients with T2D.…”

Section: Introductionmentioning

confidence: 99%

“…Type 2 diabetes (T2D) is a chronic health condition that has led to disability and increased mortality worldwide 1 . The rate of major adverse cardiovascular events (MACE) is substantially higher in people with T2D compared with those without T2D (8.2% vs. 4.2%) 2 . Cardiovascular disease (CVD) is the major cause of death in patients with T2D.…”

Section: Introductionmentioning

confidence: 99%

Some patients with type 2 diabetes may benefit from intensive glycaemic and blood pressure control: A post‐hoc machine learning analysis of ACCORD trial data

Jiao,

Kianmehr,

Lin

et al. 2024

Diabetes Obesity Metabolism

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AimThe action to control cardiovascular risk in diabetes (ACCORD) trial showed a neutral average treatment effect of intensive blood glucose and blood pressure (BP) controls in preventing major adverse cardiovascular events (MACE) in individuals with type 2 diabetes. Yet, treatment effects across patient subgroups have not been well understood. We aimed to identify patient subgroups that might benefit from intensive glucose or BP controls for preventing MACE.Materials and methodsAs a post‐hoc analysis of the ACCORD trial, we included 10 251 individuals with type 2 diabetes. We applied causal forest and causal tree models to identify participant characteristics that modify the efficacy of intensive glucose or BP controls from 68 candidate variables (demographics, comorbidities, medications and biomarkers) at the baseline. The exposure was (a) intensive versus standard glucose control [glycated haemoglobin (HbA1c) <6.0% vs. 7.0%‐7.9%], and (b) intensive versus standard BP control (systolic BP <120 vs. <140 mmHg). The primary outcome was MACE.ResultsCompared with standard glucose control, intensive one reduced MACE in those with baseline HbA1c <8.5% [relative risk (RR): 0.79, 95% confidence interval (CI): 0.67‐0.93] and those with estimated glomerular filtration rate ≥106 ml/min/1.73 m2 (RR: 0.74, 95% CI: 0.55‐0.99). Intensive BP control reduced MACE in those with normal high‐density lipoprotein levels (women >55 mg/dl, men >45 mg/dl; RR: 0.51, 95% CI: 0.34‐0.74). Risk reductions were not significant in other patient subgroups.ConclusionsOur findings suggest heterogeneous treatment effects of intensive glucose and BP control and could provide biomarkers for future clinical trials to identify more precise HbA1c and BP treatment goals for individualized medicine.

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“…Similarly, individuals with impaired kidney function and increased urinary albumin excretion have a twofold to fourfold higher risk of developing CVD than those whose kidney function is normal [17]. In patients with established CVD, coexisting diabetes or CKD is associated with worse outcomes and a higher mortality rate [18][19][20]. Early detection and timely intervention are, therefore, paramount to the prevention and management of this trifecta of conditions.…”

Section: Introductionmentioning

confidence: 99%

EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (the EXTEND45 Study): Protocol for an Australian Linked Cohort Study

Foote¹,

Hockham²,

Sukkar³

et al. 2020

JMIR Res Protoc

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Background Chronic kidney disease (CKD) and diabetes are the major causes of death and disability worldwide. They are associated with high health service utilization persisting over many years. Their slow progression and wide clinical variation make them eminently suitable for study in population-based cohorts. However, current understanding of their prevalence, incidence, and progression is largely based on studies conducted in clinical populations. Objective This study aims to establish a novel link between an existing population-based cohort (the 45 and Up Study) and routinely collected laboratory and administrative data to facilitate research across the full disease spectrum of CKD and diabetes. Methods In the EXTEND45 Study (EXamining OuTcomEs in chroNic Disease in the 45 and Up Study), baseline questionnaire responses of over 260,000 participants of the 45 and Up Study aged ≥45 years living in New South Wales (NSW), collected between January 2006 and December 2009, are linked to data from laboratory service providers as well as national- and state-based administrative datasets via probabilistic linkage. Routinely collected data were obtained for participants who could be linked between January 2005 and July 2013. Laboratory data will enable the identification of early cases of chronic disease and the assessment of clinically relevant biochemical targets during the disease course. Health administrative datasets will allow for the examination of health service use, pharmacological management, and clinical outcomes. Results The study received ethics approval from the NSW Population and Health Services Research Ethics Committee in February 2014. Data linkage for 267,153 of the 45 and Up Study participants was completed in June 2016, with congruent linkage achieved for 265,086 (99.23%) individuals. To date, the CKD and diabetes cohorts have been identified (published elsewhere), and a diverse portfolio of research projects relating to disease burden, risk factors, health outcomes, and health service utilization is in development. Conclusions The EXTEND45 Study represents an unparalleled opportunity to perform extensive research into diseases of considerable public health and clinical importance. Strengths include the population-based nature of the cohort and the availability of longitudinal information on the complete disease pathway for affected individuals. International Registered Report Identifier (IRRID) RR1-10.2196/15646

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Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization

Abstract: Supplemental Digital Content is available in the text

Cited by 10 publications

References 45 publications

Serum metabolite profile associated with incident type 2 diabetes in Koreans: findings from the Korean Genome and Epidemiology Study

Serum metabolite profile associated with incident type 2 diabetes in Koreans: findings from the Korean Genome and Epidemiology Study

Some patients with type 2 diabetes may benefit from intensive glycaemic and blood pressure control: A post‐hoc machine learning analysis of ACCORD trial data

EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (the EXTEND45 Study): Protocol for an Australian Linked Cohort Study

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