The Gender-Specific Impact of Diabetes and Myocardial Infarction at Baseline and During Follow-Up on Mortality From All Causes and Coronary Heart Disease

Abstract

In men, MI at baseline or during follow-up confers a greater risk on CHD mortality than diabetes does. In women, prior MI at baseline confers a lower risk on CHD mortality than prior diabetes does, but incident MI during follow-up confers a greater risk than incident diabetes does. In both men and women, total mortality is similar for incident MI and diabetes.

The effect of diabetes and stroke at baseline and during follow-up on stroke mortality

“…Coronary heart disease has been identified as the leading cause of death among patients with type 2 diabetes [2]. In recent years, several studies have compared the magnitude of the risk of a history of type 2 diabetes and myocardial infarction on subsequent coronary mortality [6][7][8][9][10][11][12][13]. A Finnish prospective study found that the risk of coronary death among diabetic subjects without prior myocardial infarction was similar to that in non-diabetic subjects with prior myocardial infarction [6], but this finding has been challenged by several later studies [8][9][10][11][12][13].…”

“…The analyses of data from the Finland Cardiovascular Risk (FINRISK) study revealed that, among men, the risk of coronary mortality is greater in those with myocardial infarction at baseline or during follow-up than in those with diabetes. In women, however, prior myocardial infarction at baseline confers a lower risk of coronary mortality than prior diabetes does, but incident myocardial infarction during follow-up confers a greater risk than incident diabetes does [13]. Several studies have recently assessed the relationship between type 2 diabetes and the risk of stroke.…”

“…Recent studies have investigated whether a history of myocardial infarction has the same risk on coronary death as a history of type 2 diabetes [6][7][8][9][10][11][12][13]. Our previous study reported that, among men, those who experienced myocardial infarction at baseline or during follow-up were at greater risk of coronary mortality than those with prior or incident diabetes; in women, prior myocardial infarction at baseline was associated with a lower risk of coronary mortality than prior diabetes, but incident myocardial infarction during follow-up was associated with a greater risk than incident diabetes [13]. Several prospective studies have assessed the independent effect of type 2 diabetes on stroke risk, with inconsistent results.…”

Problems of hypoglycemic therapy in diabetic patients with acute coronary syndrome

“…авторы делают вывод, что СД2 у женщин является даже более мощным фактором риска смерти, чем наличие ССС в анамнезе [62]. По сути, субанализ в подгруппе женщин в EXAMINE является первым доказательным ответом на обоснованное ранее положение о необходимости раз-работки индивидуальных стратегий лечения для сниже-ния сердечно-сосудистых риска и смертности, что осо-бенно важно у женщин с СД [63][64].…”

Wytyczne ESC dotyczące cukrzycy, stanu przedcukrzycowego i chorób układu sercowo- -naczyniowego opracowane we współpracy z EASD

“…Kobiety z nowo rozpoznaną cukrzycą typu 2 są obciążone większym ryzykiem względnym zgonu z przyczyn sercowo-naczyniowych niż mężczyźni [20,[50][51][52]. W pracy przeglądowej dotyczącej wpływu płci na liczbę zgonów spowodowanych chorobą wieńcową (CAD) wykazano, że ogólne ryzyko względne (stosunek ryzyka u kobiet do ryzyka u mężczyzn) wynosiło 1,46 (95% CI 1,21-1,95) u chorych na cukrzycę i 2,29 (95% CI 2,05-2,55) u osób bez cukrzycy, co sugeruje, że u chorych na cukrzycę nastę-puje zmniejszenie różnic między płciami w odniesieniu do CAD [53].…”