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Diabetes Is Associated With Worse Long-term Outcomes in Young Adults After Myocardial Infarction: The Partners YOUNG-MI Registry.

Authors
  • Divakaran, Sanjay1, 2
  • Singh, Avinainder1, 3
  • Biery, David1
  • Yang, Junjie1
  • DeFilippis, Ersilia M4
  • Collins, Bradley L4
  • Ramsis, Mattheus1
  • Qamar, Arman2
  • Hainer, Jon1
  • Klein, Josh1
  • Cannon, Christopher P2
  • Polk, Donna M2
  • Plutzky, Jorge2
  • Nasir, Khurram3
  • Januzzi, James L5
  • Di Carli, Marcelo F1, 2
  • Bhatt, Deepak L2
  • Blankstein, Ron6, 2
  • 1 Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • 2 Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • 3 Department of Medicine, Yale University School of Medicine, New Haven, CT.
  • 4 Department of Medicine, New York Presbyterian-Columbia University Irving Medical Center, New York, NY.
  • 5 Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, and the Baim Institute for Clinical Research, Boston, MA.
  • 6 Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA [email protected]
Type
Published Article
Journal
Diabetes care
Publication Date
Aug 01, 2020
Volume
43
Issue
8
Pages
1843–1850
Identifiers
DOI: 10.2337/dc19-0998
PMID: 31548242
Source
Medline
Language
English
License
Unknown

Abstract

We sought to determine the prevalence of diabetes and associated cardiovascular outcomes in a contemporary cohort of young individuals presenting with their first myocardial infarction (MI) at age ≤50 years. We retrospectively analyzed records of patients presenting with a first type 1 MI at age ≤50 years from 2000 to 2016. Diabetes was defined as a hemoglobin A1c ≥6.5% (48 mmol/mol) or a documented diagnosis of or treatment for diabetes. Vital status was ascertained for all patients, and cause of death was adjudicated. Among 2,097 young patients who had a type 1 MI (mean age 44.0 ± 5.1 years, 19.3% female, 73% white), diabetes was present in 416 (20%), of whom 172 (41%) were receiving insulin. Over a median follow-up of 11.2 years (interquartile range 7.3-14.2 years), diabetes was associated with a higher all-cause mortality (hazard ratio 2.30; P < 0.001) and cardiovascular mortality (2.68; P < 0.001). These associations persisted after adjusting for baseline covariates (all-cause mortality: 1.65; P = 0.008; cardiovascular mortality: 2.10; P = 0.004). Diabetes was present in 20% of patients who presented with their first MI at age ≤50 years and was associated with worse long-term all-cause and cardiovascular mortality. These findings highlight the need for implementing more aggressive therapies aimed at preventing future adverse cardiovascular events in this population. © 2019 by the American Diabetes Association.

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