Abnormal glucose metabolism in acute myocardial infarction: influence on left ventricular function and prognosis

Dan E Høfsten, Brian B Løgstrup, Jacob E Møller, Patricia A Pellikka, Kenneth Egstrup

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Udgivelsesdato: 2009-May
OriginalsprogEngelsk
TidsskriftJACC - Cardiovascular Imaging
Vol/bind2
Udgave nummer5
Sider (fra-til)592-9
Antal sider7
ISSN1936-878X
DOI
StatusUdgivet - 1. maj 2009

Fingeraftryk

Left Ventricular Function
Confidence Intervals
Glucose Intolerance
Brain Natriuretic Peptide
Glucose Tolerance Test
Infarction
Incidence

Citer dette

Høfsten, Dan E ; Løgstrup, Brian B ; Møller, Jacob E ; Pellikka, Patricia A ; Egstrup, Kenneth. / Abnormal glucose metabolism in acute myocardial infarction: influence on left ventricular function and prognosis. I: JACC - Cardiovascular Imaging. 2009 ; Bind 2, Nr. 5. s. 592-9.
@article{09b94240909011debe4e000ea68e967b,
title = "Abnormal glucose metabolism in acute myocardial infarction: influence on left ventricular function and prognosis",
abstract = "OBJECTIVES: We studied the influence of abnormal glucose metabolism on left ventricular (LV) function and prognosis in 203 patients with acute myocardial infarction. BACKGROUND: Abnormal glucose metabolism is associated with increased mortality after acute myocardial infarction. This appears to be particularly attributable to an increased incidence of post-infarction congestive heart failure. A relationship between glucose metabolism and LV function could potentially explain this excess mortality. METHODS: In patients without known diabetes, glucose metabolism was determined using an oral glucose tolerance test before discharge. LV function was assessed using echocardiographic measurements (LV end-diastolic volume, LV end-systolic volume, LV ejection fraction, restrictive diastolic filling pattern, early transmitral flow velocity to early diastolic mitral annular velocity ratio [E/e'], and left atrial volume index) and by measuring plasma N-terminal pro-B-type natriuretic peptide levels. RESULTS: After adjustment for age and gender, a linear relationship between the degree of abnormal glucose metabolism was observed for each marker of LV dysfunction (p(trend) < 0.05) with the exception of left atrial volume index (p = 0.10). During a median follow-up of 21 months, 32 patients died, and 39 patients met the secondary end point of death or hospitalization for heart failure. After adjustment for differences in LV function, as well as other relevant characteristics, newly detected, as well as known diabetes were independent predictors of both all-cause mortality (hazard ratios [HR]: 4.2 [95{\%} confidence interval (CI): 1.1 to 17.1] and HR: 5.7 [95{\%} CI: 1.3 to 25.2], respectively), and the composite of death or hospitalization for heart failure (HR: 4.3 [95{\%} CI: 1.2 to 15.6] and HR: 5.8 [95{\%} CI: 1.5 to 22.3], respectively). Comparable nonsignificant trends were observed for patients with impaired glucose tolerance. CONCLUSIONS: Although perturbations in glucose metabolism were linearly associated with impairment of LV function in the early phase of acute myocardial infarction, this relationship alone did not explain the excess mortality in patients with newly detected or known diabetes.",
keywords = "Aged, Aged, 80 and over, Biological Markers, Blood Glucose, Diabetes Mellitus, Echocardiography, Doppler, Female, Follow-Up Studies, Glucose Intolerance, Glucose Tolerance Test, Heart Failure, Hospitalization, Humans, Kaplan-Meiers Estimate, Linear Models, Male, Middle Aged, Myocardial Infarction, Natriuretic Peptide, Brain, Peptide Fragments, Prevalence, Prognosis, Proportional Hazards Models, Risk Assessment, Risk Factors, Time Factors, Ventricular Dysfunction, Left, Ventricular Function, Left",
author = "H{\o}fsten, {Dan E} and L{\o}gstrup, {Brian B} and M{\o}ller, {Jacob E} and Pellikka, {Patricia A} and Kenneth Egstrup",
year = "2009",
month = "5",
day = "1",
doi = "10.1016/j.jcmg.2009.03.007",
language = "English",
volume = "2",
pages = "592--9",
journal = "J A C C: Cardiovascular Imaging",
issn = "1936-878X",
publisher = "Elsevier",
number = "5",

}

Abnormal glucose metabolism in acute myocardial infarction: influence on left ventricular function and prognosis. / Høfsten, Dan E; Løgstrup, Brian B; Møller, Jacob E; Pellikka, Patricia A; Egstrup, Kenneth.

I: JACC - Cardiovascular Imaging, Bind 2, Nr. 5, 01.05.2009, s. 592-9.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Abnormal glucose metabolism in acute myocardial infarction: influence on left ventricular function and prognosis

AU - Høfsten, Dan E

AU - Løgstrup, Brian B

AU - Møller, Jacob E

AU - Pellikka, Patricia A

AU - Egstrup, Kenneth

PY - 2009/5/1

Y1 - 2009/5/1

N2 - OBJECTIVES: We studied the influence of abnormal glucose metabolism on left ventricular (LV) function and prognosis in 203 patients with acute myocardial infarction. BACKGROUND: Abnormal glucose metabolism is associated with increased mortality after acute myocardial infarction. This appears to be particularly attributable to an increased incidence of post-infarction congestive heart failure. A relationship between glucose metabolism and LV function could potentially explain this excess mortality. METHODS: In patients without known diabetes, glucose metabolism was determined using an oral glucose tolerance test before discharge. LV function was assessed using echocardiographic measurements (LV end-diastolic volume, LV end-systolic volume, LV ejection fraction, restrictive diastolic filling pattern, early transmitral flow velocity to early diastolic mitral annular velocity ratio [E/e'], and left atrial volume index) and by measuring plasma N-terminal pro-B-type natriuretic peptide levels. RESULTS: After adjustment for age and gender, a linear relationship between the degree of abnormal glucose metabolism was observed for each marker of LV dysfunction (p(trend) < 0.05) with the exception of left atrial volume index (p = 0.10). During a median follow-up of 21 months, 32 patients died, and 39 patients met the secondary end point of death or hospitalization for heart failure. After adjustment for differences in LV function, as well as other relevant characteristics, newly detected, as well as known diabetes were independent predictors of both all-cause mortality (hazard ratios [HR]: 4.2 [95% confidence interval (CI): 1.1 to 17.1] and HR: 5.7 [95% CI: 1.3 to 25.2], respectively), and the composite of death or hospitalization for heart failure (HR: 4.3 [95% CI: 1.2 to 15.6] and HR: 5.8 [95% CI: 1.5 to 22.3], respectively). Comparable nonsignificant trends were observed for patients with impaired glucose tolerance. CONCLUSIONS: Although perturbations in glucose metabolism were linearly associated with impairment of LV function in the early phase of acute myocardial infarction, this relationship alone did not explain the excess mortality in patients with newly detected or known diabetes.

AB - OBJECTIVES: We studied the influence of abnormal glucose metabolism on left ventricular (LV) function and prognosis in 203 patients with acute myocardial infarction. BACKGROUND: Abnormal glucose metabolism is associated with increased mortality after acute myocardial infarction. This appears to be particularly attributable to an increased incidence of post-infarction congestive heart failure. A relationship between glucose metabolism and LV function could potentially explain this excess mortality. METHODS: In patients without known diabetes, glucose metabolism was determined using an oral glucose tolerance test before discharge. LV function was assessed using echocardiographic measurements (LV end-diastolic volume, LV end-systolic volume, LV ejection fraction, restrictive diastolic filling pattern, early transmitral flow velocity to early diastolic mitral annular velocity ratio [E/e'], and left atrial volume index) and by measuring plasma N-terminal pro-B-type natriuretic peptide levels. RESULTS: After adjustment for age and gender, a linear relationship between the degree of abnormal glucose metabolism was observed for each marker of LV dysfunction (p(trend) < 0.05) with the exception of left atrial volume index (p = 0.10). During a median follow-up of 21 months, 32 patients died, and 39 patients met the secondary end point of death or hospitalization for heart failure. After adjustment for differences in LV function, as well as other relevant characteristics, newly detected, as well as known diabetes were independent predictors of both all-cause mortality (hazard ratios [HR]: 4.2 [95% confidence interval (CI): 1.1 to 17.1] and HR: 5.7 [95% CI: 1.3 to 25.2], respectively), and the composite of death or hospitalization for heart failure (HR: 4.3 [95% CI: 1.2 to 15.6] and HR: 5.8 [95% CI: 1.5 to 22.3], respectively). Comparable nonsignificant trends were observed for patients with impaired glucose tolerance. CONCLUSIONS: Although perturbations in glucose metabolism were linearly associated with impairment of LV function in the early phase of acute myocardial infarction, this relationship alone did not explain the excess mortality in patients with newly detected or known diabetes.

KW - Aged

KW - Aged, 80 and over

KW - Biological Markers

KW - Blood Glucose

KW - Diabetes Mellitus

KW - Echocardiography, Doppler

KW - Female

KW - Follow-Up Studies

KW - Glucose Intolerance

KW - Glucose Tolerance Test

KW - Heart Failure

KW - Hospitalization

KW - Humans

KW - Kaplan-Meiers Estimate

KW - Linear Models

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Natriuretic Peptide, Brain

KW - Peptide Fragments

KW - Prevalence

KW - Prognosis

KW - Proportional Hazards Models

KW - Risk Assessment

KW - Risk Factors

KW - Time Factors

KW - Ventricular Dysfunction, Left

KW - Ventricular Function, Left

U2 - 10.1016/j.jcmg.2009.03.007

DO - 10.1016/j.jcmg.2009.03.007

M3 - Journal article

VL - 2

SP - 592

EP - 599

JO - J A C C: Cardiovascular Imaging

JF - J A C C: Cardiovascular Imaging

SN - 1936-878X

IS - 5

ER -