Population based absolute and relative survival to 1 year of people with diabetes following a myocardial infarction: A cohort study using hospital admissions data

Brophy, Sinéad; Cooksey, Roxanne; Gravenor, Michael B.; Weston, Clive; Macey, Steven Michael; John, Gareth; Williams, Rhys; Lyons, Ronan A.

doi:10.1186/1471-2458-10-338

Cited by 19 publications

(17 citation statements)

References 16 publications

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“…This could result in death caused by heart failure or sudden death because of an arrhythmia in patients with established CAD (30). Prior studies found that in patients with a myocardial infarction or a percutaneous coronary intervention, diabetes increases the risk of recurrent MCVE 1.5 to 2.0 times (31)(32)(33). These studies assessed the recurrence of myocardial infarction or death but not a composite of vascular events as in the current study.…”

Section: Discussionmentioning

confidence: 99%

Effect of Type 2 Diabetes on Recurrent Major Cardiovascular Events for Patients With Symptomatic Vascular Disease at Different Locations

et al. 2015

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OBJECTIVEOur aim is to compare the effect of type 2 diabetes on recurrent major cardiovascular events (MCVE) for patients with symptomatic vascular disease at different locations. RESEARCH DESIGN AND METHODSA total of 6,841 patients from the single-center, prospective Second Manifestations of ARTerial disease (SMART) cohort study from Utrecht, the Netherlands, with clinically manifest vascular disease with (n = 1,155) and without (n = 5,686) type 2 diabetes were monitored between 1996 and 2013. The effect of type 2 diabetes on recurrent MCVE was analyzed with Cox proportional hazards models, stratified for disease location (cerebrovascular disease, peripheral artery disease, abdominal aortic aneurysm, coronary artery disease, or polyvascular disease, defined as ‡2 vascular locations). RESULTSFive-year risks for recurrent MCVE were 9% in cerebrovascular disease, 9% in peripheral artery disease, 20% in those with an abdominal aortic aneurysm, 7% in coronary artery disease, and 21% in polyvascular disease. Type 2 diabetes increased the risk of recurrent MCVE in coronary artery disease (hazard ratio [HR] 1.67; 95% CI 1.25-2.21) and seemed to increase the risk in cerebrovascular disease (HR 1.36; 95% CI 0.90-2.07), while being no risk factor in polyvascular disease (HR 1.12; 95% CI 0.83-1.50). Results for patients with peripheral artery disease (HR 1.42; 95% CI 0.79-2.56) or an abdominal aortic aneurysm (HR 0.93; 95% CI 0.23-3.68) were inconclusive. CONCLUSIONSType 2 diabetes increased the risk of recurrent MCVE in patients with coronary artery disease, but there is no convincing evidence that it is a major risk factor for subsequent MCVE in all patients with symptomatic vascular disease.Type 2 diabetes has a significant effect on a patient's life expectancy, with a recently estimated loss of 6 life-years (1). Reduced life expectancy in these patients is mainly attributable to a higher incidence of vascular disease and heart failure (2-4). Type 2 diabetes increases the risk of cerebrovascular disease (CeVD) by 35% and peripheral

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Section: Discussionmentioning

confidence: 99%

Effect of Type 2 Diabetes on Recurrent Major Cardiovascular Events for Patients With Symptomatic Vascular Disease at Different Locations

et al. 2015

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“…Diabetes was confirmed to be a strong risk factor for recurrence for both men and women and for all age groups. 15,16,34 Because of the limited information available in the dataset used for this study, the effect of the main coronary risk factors (smoking status, high blood cholesterol levels, and high blood pressure), which have been shown to affect AMI recurrence, 15 could not be assessed. Other factors that may have influenced recurrence, but could not be investigated in this study, include infarct severity, pharmaceutical treatment, psychological factors, social environment, and patient compliance with drug therapy and advice on physical activity, weight control, and healthy diet.…”

Section: Risk Of a Second Amimentioning

confidence: 99%

“…36 Linked Scottish Morbidity Record Database and Patient Episode Database for Wales, equivalents of the English HES, were reported to have high accuracy rates for the diagnosis of AMI. 16,37 Further limitations include the absence of clinical information, making it impossible to adjust for coronary risk factors and infarct severity, or to report on the diagnostic criteria used in making the clinical diagnosis of AMI. HES records do not contain information on drug prescriptions and thus treatment effect could not be examined.…”

Section: Study Strengths and Limitationsmentioning

confidence: 99%

“…Yet, only a few such studies have examined long-term prognosis in unselected patient populations, measured as long-term survival and as risk of recurrence. 4,10,[13][14][15][16][17] Of those that have, most used a combined end point of recurrent AMI or death from any cause [14][15][16] but did not analyze risks of recurrent event and death separately. 10,17 One possible means for obtaining information on prognosis is the analysis of routinely collected national hospital admission and death certificate data.…”

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confidence: 99%

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Long-Term Survival and Recurrence After Acute Myocardial Infarction in England, 2004 to 2010

Smolina

Wright

Rayner

et al. 2012

Circ: Cardiovascular Quality and Outcomes

224

169

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Background— There are limited population-based national data on prognosis in survivors of acute myocardial infarction (AMI), particularly on long-term survival and the risk of recurrence. Methods and Results— Record linkage of hospital and mortality data identified 387 452 individuals in England who were admitted to hospital with a main diagnosis of AMI between 2004 and 2010 and who survived for at least 30 days. Seven years after an AMI, the risk of death from any cause in survivors of first or recurrent AMI was, respectively, 2 and 3 times higher than that in the English general population of equivalent age. For all survivors of a first AMI, the risk of a second AMI was highest during the first year and the cumulative risk increased more gradually thereafter. For men, 1- and 7-year cumulative risks were 5.6% (95% confidence interval [CI], 5.5–5.7) and 13.9% (95% CI, 13.7–14.1); for women, they were 7.2% (95% CI, 7.1–7.4) and 16.2% (95% CI, 16.0–16.5). Older age, higher deprivation, no revascularization procedures, and presence of comorbidities were associated with higher recurrence risk. Conclusions— Survivors of both first and recurrent AMI remained at a significantly higher risk of death compared with the general population for at least 7 years after the event. For survivors of first AMI, the influence of predisposing factors for second AMI lessened with time after the initial event. The results reinforce the importance of acute clinical care and secondary prevention in improving long-term prognosis of hospitalized AMI patients.

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“…It is well established that patients with diabetes mellitus have an increased risk of mortality and morbidity from cardiovascular disease compared to the general population [1,2,3,4,5,6,7,8,9,10]. A number of studies have also been published evaluating the impact of different regimens on the excess mortality observed [11,12,13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Survival in Type 1 and Type 2 Diabetes in a Population Referred for Invasive Evaluation of Coronary Disease

Mølstad¹,

Rødevand²

2017

Cardiology

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Objectives: To evaluate long-term and time trends of survival in patients with a clinical diagnosis of type 1 and type 2 diabetes compared to patients without diabetes in a population referred for invasive treatment of coronary disease. Methods: Patients examined for heart disease at the Feiring LHL Clinics from March 1999 until December 2014 were followed for survival until 20 September, 2015. This yielded 43,872 patients with a known survival status including 1,326 (3.0%) patients with type 1 diabetes and 4,564 (10.9%) with type 2 diabetes. Results: Cox regression revealed a hazard ratio (HR) in type 1 and type 2 diabetes, respectively, of 1.78 (95% confidence interval [CI] 1.60-1.99) and 1.29 (95% CI 1.21-1.37). Comparing survival in the treatment periods before and after 2007, patients without diabetes and with type 2 diabetes had a reduced HR of 0.78 (95% CI 0.72-0.84) and 0.76 (95% CI 0.63-0.91), respectively, but there was no reduction in type 1 diabetes (HR 1.03; 95% CI 0.74-1.42). Conclusions: Type 1 and type 2 diabetes have excess long-term mortality. In the nondiabetic and type 2 diabetic patients, a reduction in mortality has been noted in recent years, but has not been observed in type 1 diabetic patients.

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Population based absolute and relative survival to 1 year of people with diabetes following a myocardial infarction: A cohort study using hospital admissions data

Cited by 19 publications

References 16 publications

Effect of Type 2 Diabetes on Recurrent Major Cardiovascular Events for Patients With Symptomatic Vascular Disease at Different Locations

Effect of Type 2 Diabetes on Recurrent Major Cardiovascular Events for Patients With Symptomatic Vascular Disease at Different Locations

Long-Term Survival and Recurrence After Acute Myocardial Infarction in England, 2004 to 2010

Survival in Type 1 and Type 2 Diabetes in a Population Referred for Invasive Evaluation of Coronary Disease

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