Is diabetes an independent risk factor for mortality after myocardial infarction? The ARIC (Atherosclerosis Risk in Communities) Surveillance Study

S. Weitzman, C. Wang, W. D. Rosamond, L. E. Chambless, L. S. Cooper, Eyal Shahar, D. C. Goff

Research output: Contribution to journalArticle

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Abstract

We investigated the age-, gender- and race-specific 1-year case fatality rates of diabetic and non-diabetic individuals with a myocardial infarction. Data were obtained from the Atherosclerosis Risk in Communities (ARIC) Surveillance Study, which monitors both hospitalized myocardial infarction and coronary heart disease (CHD) deaths in residents aged 35-74 years in four communities in the USA. The study population comprised 3242 hospitalized myocardial infarctions (HMIs) in diabetic subjects and 9826 HMIs in non-diabetic individuals between 1987 and 1997. Age-adjusted and gender- and race-specific odds ratios (OR) for 1-year case fatality comparing diabetic to non-diabetic patients were 2.0 (95% CI, 1.6-2.4) for white men and 1.4 (95% CI, 1.1-1.8) for white women. Further adjustment for severity of HMI, history of previous MI, stroke and hypertension, and therapy variables showed significantly higher case fatality in white diabetic men than in non-diabetic white men (OR=1.5; 95% CI, 1.2-1.9), but no significant association in the other race-gender groups. The age-adjusted odds of out of hospital death was significantly higher among white diabetic men (OR=1.7; 95% CI, 1.2-2.3), white women (OR=2.3; 95% CI, 1.4-3.8), and African-American women (OR=2.9; 95% CI, 1.5-5.9) as compared to their non-diabetic counterparts. In conclusion, diabetes is an independent factor for mortality within one year following a myocardial infarction among white men, and following out-of hospital coronary death in white men and women and in African-American women. It is possible that these differences could be explained, at least in part, by a less than optimal medical management of the high cardiovascular risk profile of these patients after hospital discharge.

Original languageEnglish (US)
Pages (from-to)77-83
Number of pages7
JournalActa Diabetologica
Volume41
Issue number2
StatePublished - Jun 2004
Externally publishedYes

Fingerprint

Atherosclerosis
Myocardial Infarction
Odds Ratio
Mortality
African Americans
Coronary Disease
Stroke
Hypertension
Population
Therapeutics

Keywords

  • Case-fatality
  • Diabetes mortality
  • Gender differences
  • Myocardial infarction
  • Racial differences

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Is diabetes an independent risk factor for mortality after myocardial infarction? The ARIC (Atherosclerosis Risk in Communities) Surveillance Study. / Weitzman, S.; Wang, C.; Rosamond, W. D.; Chambless, L. E.; Cooper, L. S.; Shahar, Eyal; Goff, D. C.

In: Acta Diabetologica, Vol. 41, No. 2, 06.2004, p. 77-83.

Research output: Contribution to journalArticle

Weitzman, S. ; Wang, C. ; Rosamond, W. D. ; Chambless, L. E. ; Cooper, L. S. ; Shahar, Eyal ; Goff, D. C. / Is diabetes an independent risk factor for mortality after myocardial infarction? The ARIC (Atherosclerosis Risk in Communities) Surveillance Study. In: Acta Diabetologica. 2004 ; Vol. 41, No. 2. pp. 77-83.
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