Survival after first MI remains poor among diabetics
MedWire News: Long-term survival after a first myocardial infarction (MI) is significantly lower among patients with diabetes than those without the condition, researchers report.
Although survival has improved overall, the difference between diabetic and nondiabetic patients remains substantial, with the disparity even greater in women than in men, they say.
Led by Mats Eliasson (Umea University, Sweden), the researchers used the Northern Sweden MONICA Myocardial Infarction Registry to identify 6776 patients, aged 25-64 years, who had been diagnosed with a definite first MI between 1989 and 2006. They followed-up on patients for vital status until 20 August 2008, using The Swedish Cause of Death Registry.
As reported in the journal Diabetologia, the patients were separated into groups representing the year of onset of MI, to create three cohorts (1989-1994, 1995-2000, and 2001-2006).
The authors found that, across each of the three successive cohorts, mortality rates decreased among both the diabetic and nondiabetic patients. However, within each cohort the mortality rate was higher among the diabetic patients, they say.
The median length of survival was 227 months for nondiabetic patients compared with 115 months for diabetic patients. Cox regression analysis revealed that diabetic patients were at a 1.65 times greater risk of all-cause mortality than nondiabetic patients.
Further analysis revealed that the higher mortality rate among diabetic patients was more pronounced among women then among men.
Median survival time for nondiabetic men was 227 months and for diabetic men 123 months, whereas corresponding survival time for women was 222 and 81 months, respectively.
"Patients with diabetes have seemingly benefited from the implementation of evidence-based cardiovascular prevention and intervention, but these measures have not reduced their excess mortality risk," write Eliasson and colleagues.
They add that "further analyses of long-term outcome when best available care has persistently been delivered over prolonged periods may elucidate the answers to these questions."
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By Sally Robertson