Prognosis following first acute myocardial infarction in Type 2 diabetes: a comparative population study

Donnan, Peter T.; Boyle, Douglas; Broomhall, J; Hunter, Karen; MacDonald, Thomas M.; Newton, R. W.; Morris, Andrew D.

doi:10.1046/j.1464-5491.2002.00711.x

Cited by 60 publications

(52 citation statements)

References 25 publications

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“…4,5 Patients with type 2 diabetes not only have more extensive cardiovascular disease (CVD), but they also have a higher prevalence of hypertension, heart failure, peripheral vascular disease, and neuropathy. 6 Type 2 diabetes is an independent risk factor for all types of CVDs, as well as long-term mortality and need for revascularization.…”

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confidence: 99%

Clinical Outcomes and Medication Adherence in Acute Coronary Syndrome Patients With and Without Type 2 Diabetes Mellitus: A Longitudinal Analysis 2006-2011

Cziraky¹,

Reddy²,

Luthra³

et al. 2015

JMCP

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confidence: 99%

Clinical Outcomes and Medication Adherence in Acute Coronary Syndrome Patients With and Without Type 2 Diabetes Mellitus: A Longitudinal Analysis 2006-2011

Cziraky¹,

Reddy²,

Luthra³

et al. 2015

JMCP

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“…A number of studies have found relationships between the macrovascular (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and microvascular complications of diabetes and mortality. However, many of these studies assessed complications individually, failing to consider other putative risk factors and complications.…”

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confidence: 99%

Associations of Mortality and Diabetes Complications in Patients With Type 1 and Type 2 Diabetes

et al. 2005

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OBJECTIVE—Diabetes is a leading cause of morbidity and mortality. The purpose of this study is to assess the associations between diabetes complications and mortality in the Early Treatment Diabetic Retinopathy Study (ETDRS). RESEARCH DESIGN AND METHODS—We examined demographic, clinical, and laboratory characteristics of the 3,711 subjects enrolled in the ETDRS, a randomized controlled clinical trial designed to evaluate the role of laser photocoagulation and aspirin therapy for diabetic retinopathy. The outcome assessed was all-cause mortality. Multivariable Cox proportional hazards regression was used to assess associations between diabetes complications and mortality for type 1 and type 2 diabetes separately. RESULTS—The 5-year estimates of all-cause mortality were 5.5 and 18.9% for patients with type 1 and type 2 diabetes, respectively. In patients with type 1 diabetes, amputation (hazard ratio [HR] 5.08 [95% CI 2.06–12.54]) and poor visual acuity (1.74 [1.10–2.75]) remained significantly associated with mortality, after adjusting for other diabetes complications and baseline characteristics. In patients with type 2 diabetes, macrovascular disease and worsening levels of nephropathy, neuropathy, retinopathy, and visual acuity are associated with progressively increasing risks of mortality, after controlling for other baseline risk factors. CONCLUSIONS—Amputation is the strongest predictor for mortality in patients with type 1 diabetes. All complications independently predict mortality in patients with type 2 diabetes. There is an increased risk for mortality as the degree of each complication worsens. Additional studies are needed to investigate the effectiveness of tertiary prevention to decrease mortality in these patients.

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“…Third, our study population was derived from 6 hospitals diverse in payer status, age, race/ethnicity, and socioeconomic status, increasing the potential generalizability of our findings. Fourth, our models are less likely to be overfit to the idiosyncrasies of our data given that the predictors in our final AMI‐specific models have good clinical face validity, and have been associated with adverse outcomes, particularly mortality, in prior studies of this population 28, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39…”

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confidence: 99%

Predicting 30‐Day Hospital Readmissions in Acute Myocardial Infarction: The AMI “READMITS” (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus , Nonmale Sex , Intervention with Timely Percutaneous Coronary Intervention, and Low Systolic Blood Pressure) Score

Nguyen

Makam

Clark

et al. 2018

JAHA

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BackgroundReadmissions after hospitalization for acute myocardial infarction (AMI) are common. However, the few currently available AMI readmission risk prediction models have poor‐to‐modest predictive ability and are not readily actionable in real time. We sought to develop an actionable and accurate AMI readmission risk prediction model to identify high‐risk patients as early as possible during hospitalization.Methods and ResultsWe used electronic health record data from consecutive AMI hospitalizations from 6 hospitals in north Texas from 2009 to 2010 to derive and validate models predicting all‐cause nonelective 30‐day readmissions, using stepwise backward selection and 5‐fold cross‐validation. Of 826 patients hospitalized with AMI, 13% had a 30‐day readmission. The first‐day AMI model (the AMI “READMITS” score) included 7 predictors: renal function, elevated brain natriuretic peptide, age, diabetes mellitus, nonmale sex, intervention with timely percutaneous coronary intervention, and low systolic blood pressure, had an optimism‐corrected C‐statistic of 0.73 (95% confidence interval, 0.71–0.74) and was well calibrated. The full‐stay AMI model, which included 3 additional predictors (use of intravenous diuretics, anemia on discharge, and discharge to postacute care), had an optimism‐corrected C‐statistic of 0.75 (95% confidence interval, 0.74–0.76) with minimally improved net reclassification and calibration. Both AMI models outperformed corresponding multicondition readmission models.ConclusionsThe parsimonious AMI READMITS score enables early prospective identification of high‐risk AMI patients for targeted readmissions reduction interventions within the first 24 hours of hospitalization. A full‐stay AMI readmission model only modestly outperformed the AMI READMITS score in terms of discrimination, but surprisingly did not meaningfully improve reclassification.

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Prognosis following first acute myocardial infarction in Type 2 diabetes: a comparative population study

Cited by 60 publications

References 25 publications

Clinical Outcomes and Medication Adherence in Acute Coronary Syndrome Patients With and Without Type 2 Diabetes Mellitus: A Longitudinal Analysis 2006-2011

Clinical Outcomes and Medication Adherence in Acute Coronary Syndrome Patients With and Without Type 2 Diabetes Mellitus: A Longitudinal Analysis 2006-2011

Associations of Mortality and Diabetes Complications in Patients With Type 1 and Type 2 Diabetes

Predicting 30‐Day Hospital Readmissions in Acute Myocardial Infarction: The AMI “READMITS” (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus , Nonmale Sex , Intervention with Timely Percutaneous Coronary Intervention, and Low Systolic Blood Pressure) Score

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