Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study

Norhammar, Anna; Tenerz, Åke; Nilsson, Göran; Hamsten, Anders; Efendić, Suad; Rydén, Lars; Malmberg, Klas

doi:10.1016/s0140-6736(02)09089-x

Cited by 968 publications

(701 citation statements)

References 29 publications

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“…The high prevalence of IGT (35%) and newly diagnosed type 2 diabetes (31%) in patients with AMI previously reported from this study [4] was recently confirmed by the Euro Heart Survey [17]. In this survey a majority of patients with manifest coronary heart disease had AGT.…”

Section: Discussionsupporting

confidence: 81%

“…A detailed description of the patients has been presented elsewhere [4,5]. In brief, patients admitted for AMI were included if they fulfilled the following inclusion criteria: no previously known type 2 diabetes, baseline capillary blood glucose <11.1 mmol/l, serum creatinine <200 μmol/l and age ≤80 years.…”

Section: Subjectsmentioning

confidence: 99%

“…Intraand interassay coefficients of variation for these analyses were 6% and 7%, respectively, for insulin and 5% and 6% for proinsulin. Details of biochemical analysis have been described elsewhere [4,5,14].…”

Section: Study Protocolmentioning

confidence: 99%

“…However, classification by fasting glucose may miss patients with abnormal glucose tolerance, who also have less favourable cardiovascular risk profiles [2,3]. In the GAMI (Glucose Tolerance in Patients with Acute Myocardial Infarction) study, OGTTs performed on patients without previously known type 2 diabetes but with an acute myocardial infarction (AMI) demonstrated that 35% had impaired glucose tolerance (IGT) and 31% had previously undiagnosed type 2 diabetes [4]. Newly detected abnormal glucose tolerance (AGT; IGT or type 2 diabetes) was the strongest predictor of future cardiovascular events, together with previous myo-cardial infarction and stroke [5].…”

Section: Introductionmentioning

confidence: 99%

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Beta cell dysfunction in patients with acute myocardial infarction but without previously known type 2 diabetes: a report from the GAMI study

et al. 2005

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Aims/hypothesis: Patients with acute myocardial infarction (AMI) but without previously known type 2 diabetes have a high prevalence of undiagnosed IGT and type 2 diabetes. Such perturbations have dismal prognostic implications. The aim of this study was to characterise AMI patients in terms of insulin resistance and beta cell function. Methods: A total of 168 consecutive AMI patients were classified by means of an OGTT before hospital discharge as having NGT, IGTor type 2 diabetes. The homeostasis model assessment (HOMA-IR) was used to estimate insulin resistance. Beta cell responsiveness was quantified as insulinogenic index (IGI) at 30 min (ΔI 30 /ΔG 30 (r=−0.218, p=0.010) and to the area under the curve for glucose (r=−0.475, p<0.001). Conclusions/interpretation: Glucose abnormalities are very common in patients with AMI but without previously known type 2 diabetes. To a significant extent, this seems to be related to impaired beta cell function and implies that dysglycaemia immediately after an infarction is not a stress epiphenomenon but reflects stable disturbances of glucose regulation preceding the AMI. Early beta cell dysfunction may have important pathophysiological implications and may serve as a future target for treatment strategies.

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Section: Discussionsupporting

confidence: 81%

Section: Subjectsmentioning

confidence: 99%

Section: Study Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Beta cell dysfunction in patients with acute myocardial infarction but without previously known type 2 diabetes: a report from the GAMI study

et al. 2005

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“…We had no information on medication with anticoagulants, which may ameliorate the risk of stroke, and may have influenced our results. Some of the patients without diabetes may in fact have had type 2 diabetes if tested, as shown in earlier studies 40. However, it is likely that these patients had a shorter duration of diabetes and thus may have had a lower risk of stroke.…”

Section: Discussionmentioning

confidence: 77%

Long‐Term Risk of Stroke in Patients With Type 1 and Type 2 Diabetes Following Coronary Artery Bypass Grafting

Nyström

Holzmann

Sartipy

2015

JAHA

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BackgroundWe performed a nationwide population‐based cohort study to investigate the long‐term risk of stroke after coronary artery bypass grafting in patients with type 1 and type 2 diabetes.Methods and ResultsAll patients who underwent primary coronary artery bypass grafting in Sweden from 2000 through 2011 were included from the SWEDEHEART register. We excluded patients with prior stroke, and patients who had a stroke or died within 30 days of surgery. The National Diabetes Register was used to identify patients with type 1 and type 2 diabetes. Incident stroke (ischemic and hemorrhagic), and all‐cause mortality was obtained by record linkage with the National Patient Register and the Cause of Death register. We used multivariable Cox regression to estimate the risk of stroke in relation to type of diabetes. A total of 53 820 patients (type 1 diabetes [n=714], type 2 diabetes [n=10 054], no diabetes [n=43 052]) were included. During a mean follow‐up of 7.4 years (398 337 person‐years), in total, 8.0% (n=4296) of the patients had a stroke: 7.3% (n=52) in patients with type 1 diabetes, 9.1% (n=915) in patients with type 2 diabetes, and 7.7% (n=3329) in patients with no diabetes. The multivariable adjusted hazard ratio (95% CI) for all stroke was 1.59 (1.20–2.11) in type 1 diabetes, and 1.32 (1.23–1.43) in type 2 diabetes.ConclusionsThe long‐term risk for stroke after coronary artery bypass grafting was increased in patients with type 1 and type 2 diabetes, compared to patients with no diabetes.

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Insulin Therapy for Critically Ill Hospitalized Patients

Pittas

Siegel²,

Lau³

2004

Arch Intern Med

258

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Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study

Cited by 968 publications

References 29 publications

Beta cell dysfunction in patients with acute myocardial infarction but without previously known type 2 diabetes: a report from the GAMI study

Beta cell dysfunction in patients with acute myocardial infarction but without previously known type 2 diabetes: a report from the GAMI study

Long‐Term Risk of Stroke in Patients With Type 1 and Type 2 Diabetes Following Coronary Artery Bypass Grafting

Insulin Therapy for Critically Ill Hospitalized Patients

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