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Newly diagnosed diabetes and outcomes after acute myocardial infarction in young adults.

Authors :
Qinglan Ding
Spatz, Erica S.
Lipska, Kasia J.
Haiqun Lin
Spertus, John A.
Dreyer, Rachel P.
Whittemore, Robin
Funk, Marjorie
Bueno, Hector
Krumholz, Harlan M.
Ding, Qinglan
Lin, Haiqun
Source :
Heart; Apr2021, Vol. 107 Issue 8, p657-666, 10p
Publication Year :
2021

Abstract

<bold>Objective: </bold>To examine prevalence and characteristics of newly diagnosed diabetes (NDD) in younger adults hospitalised with acute myocardial infarction (AMI) and investigate whether NDD is associated with health status and clinical outcomes over 12-month post-AMI.<bold>Methods: </bold>In individuals (18-55 years) admitted with AMI, without established diabetes, we defined NDD as (1) baseline or 1-month HbA1c≥6.5%; (2) discharge diabetes diagnosis or (3) diabetes medication initiation within 1 month. We compared baseline characteristics of NDD, established diabetes and no diabetes, and their associations with baseline, 1-month and 12-month health status (angina-specific and non-disease specific), mortality and in-hospital complications.<bold>Results: </bold>Among 3501 patients in Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients study, 14.5% met NDD criteria. Among 508 patients with NDD, 35 (6.9%) received discharge diagnosis, 91 (17.9%) received discharge diabetes education and 14 (2.8%) initiated pharmacological treatment within 1 month. NDD was more common in non-White (OR 1.58, 95% CI 1.23 to 2.03), obese (OR 1.72, 95% CI 1.39 to 2.12), financially stressed patients (OR 1.27, 95% CI 1.02 to 1.58). Compared with established diabetes, NDD was independently associated with better disease-specific health status and quality of life (p≤0.04). No significant differences were found in unadjusted in-hospital mortality and complications between NDD and established or no diabetes.<bold>Conclusions: </bold>NDD was common among adults≤55 years admitted with AMI and was more frequent in non-White, obese, financially stressed individuals. Under 20% of patients with NDD received discharge diagnosis or initiated discharge diabetes education or pharmacological treatment within 1 month post-AMI. NDD was not associated with increased risk of worse short-term health status compared with risk noted for established diabetes.<bold>Trial Registration Number: </bold>NCT00597922. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
13556037
Volume :
107
Issue :
8
Database :
Complementary Index
Journal :
Heart
Publication Type :
Academic Journal
Accession number :
149520109
Full Text :
https://doi.org/10.1136/heartjnl-2020-317101