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Korean Circ J. 2018 Feb;48(2):134-147. English. Original Article. https://doi.org/10.4070/kcj.2017.0174
Park HW , Kang MG , Kim K , Koh JS , Park JR , Jeong YH , Ahn JH , Jang JY , Kwak CH , Park Y , Jeong MH , Kim YJ , Cho MC , Kim CJ , Hwang JY , .
Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea. jyhwang@gnu.ac.kr
Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea.
Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.
Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea.
Abstract

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.

Copyright © 2019. Korean Association of Medical Journal Editors.