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Author: Eleanor McDermid
medwireNews: Results from a nationwide registry study show that having type 1 diabetes places people at a significantly increased risk for dying within a year after having a myocardial infarction (MI).
The high risk was particularly striking among people younger than 60 years, who had a 3.50-fold risk increase versus people without diabetes, compared with an increase of 2.20-fold for those aged 60–79 years and a nonsignificant 1.23-fold increase for older people.
In the full cohort of 1935 people with type 1 diabetes and 74,671 without, 13.2% versus 9.7% died while still in hospital, a corresponding 12.7% versus 9.5% died within 30 days after MI, and 25.1% versus 16.3% died within 1 year.
People with diabetes were significantly younger than those without, but more often had high-risk conditions including heart failure, renal disease, cerebrovascular disease, and peripheral vascular disease.
Nevertheless, the increased risk for MI case fatality persisted in a propensity-matched analysis involving 1787 people with diabetes and 1787 without, report Anne Kerola (Helsinki University Hospital, Finland) and co-researchers in Diabetes Care.
Among people with diabetes, factors contributing to mortality risk in multivariable analysis included heart failure, liver disease, renal failure, and peripheral vascular disease. A positive finding was that people were significantly less like to die if they had their MI after 2009 versus 2005–2009.
“Our results underscore the need for vigorous acute treatment of MI as well as for effective [cardiovascular disease] prevention strategies, including optimal glycemic control, for both men and women with type 1 diabetes,” conclude the researchers.
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