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KMID : 0368120180480020134
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Korean Circulation Journal
2018 Volume.48 No. 2 p.134 ~ p.147
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Long-term Prognosis and Clinical Characteristics of Patients with Newly Diagnosed Diabetes Mellitus Detected after First Acute Myocardial Infarction: from KAMIR-NIH Registry
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Park Hyun-Woong
Kang Min-Gyu
Kim Kye-Hwan
Koh Jin-Sin
Park Jeong-Rang
Jeong Young-Hoon
Ahn Jong-Hwa
Jang Jeong-Yoon
Kwak Choong-Hwan
Park Yong-Whi
Jeong Myung-Ho
Kim Young-Jo
Cho Myeong-Chan
Kim Chong-Jin
Hwang Jin-Yong
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Abstract
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Background and Objectives: After the first acute myocardial infarction (AMI), a considerable proportion of patients are newly diagnosed with diabetes mellitus (DM). However, in AMI, controversy remains regarding the disparity in prognosis between previously diagnosed DM (known-DM) and newly diagnosed DM (new-DM).
Methods: The study included 10,455 patients with AMI (non-DM, 6,236; new-DM, 659; known-DM, 3,560) admitted to one of 15 participating centers in Korea between November 2011 and January 2016 (average follow-up, 523 days). We compared the characteristics and clinical course of patients with known-DM and those with new- or non-DM.
Results: Compared to patients with known-DM, those with new-DM or non-DM were younger, more likely to be male, and less likely to have hypertension, dyslipidemia, prior stroke, angina, or myocardial infarction. Compared to patients with new-DM or non-DM (reference), those with known-DM had higher risks of major adverse cardiac events (hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.06?1.35; p=0.004), cardiac death (HR, 1.26; 95% CI, 1.01?1.57; p=0.042), and congestive heart failure (HR, 1.58; 95% CI, 1.20?2.08). Unlike known-DM, new-DM did not increase the risk of cardiac events (including death).
Conclusions: Known-DM was associated with a significantly higher risk of cardiovascular events after AMI, while new-DM had a similar risk of cardiac events as that noted for non-DM. There were different cardiovascular outcomes according to diabetes status in patients with AMI.
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KEYWORD
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Diabetes mellitus, Myocardial infarction, Cardiac death, Congestive heart failure
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