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Newly diagnosed and previously known diabetes mellitus and 1-year outcomes of acute myocardial infarction: the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial.
Circulation. 2004 Sep 21; 110(12):1572-8.Circ

Abstract

BACKGROUND

A prior diagnosis of diabetes mellitus is associated with adverse outcomes after acute myocardial infarction (MI), but the risk associated with a new diagnosis of diabetes in this setting has not been well defined.

METHODS AND RESULTS

We assessed the risk of death and major cardiovascular events associated with previously known and newly diagnosed diabetes by studying 14,703 patients with acute MI enrolled in the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. Patients were grouped by diabetic status: previously known diabetes (insulin use or diagnosis of diabetes before MI, n=3400, 23%); newly diagnosed diabetes (use of diabetic therapy or diabetes diagnosed at randomization [median 4.9 d after infarction], but no known diabetes at presentation, n=580, 4%); or no diabetes (n=10,719). Patients with newly diagnosed diabetes were younger and had fewer comorbid conditions than did patients with previously known diabetes. At 1 year after enrollment, patients with previously known and newly diagnosed diabetes had similarly increased adjusted risks of mortality (hazard ratio [HR] 1.43; 95% confidence interval [CI], 1.29 to 1.59 and HR, 1.50; 95% CI, 1.21 to 1.85, respectively) and cardiovascular events (HR, 1.37; 95% CI, 1.27 to 1.48 and HR, 1.34; 95% CI, 1.14 to 1.56).

CONCLUSIONS

Diabetes mellitus, whether newly diagnosed or previously known, is associated with poorer long-term outcomes after MI in high-risk patients. The poor prognosis of patients with newly diagnosed diabetes, despite having baseline characteristics similar to those of patients without diabetes, supports the idea that metabolic abnormalities contribute to their adverse outcomes.

Authors+Show Affiliations

Cardiovascular Division, University of Texas Health Science Center, 6431 Fannin, MSB 1.246, Houston, TX 77030, USA. david.aguilar@uth.tmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15364810

Citation

Aguilar, David, et al. "Newly Diagnosed and Previously Known Diabetes Mellitus and 1-year Outcomes of Acute Myocardial Infarction: the VALsartan in Acute Myocardial iNfarcTion (VALIANT) Trial." Circulation, vol. 110, no. 12, 2004, pp. 1572-8.
Aguilar D, Solomon SD, Køber L, et al. Newly diagnosed and previously known diabetes mellitus and 1-year outcomes of acute myocardial infarction: the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. Circulation. 2004;110(12):1572-8.
Aguilar, D., Solomon, S. D., Køber, L., Rouleau, J. L., Skali, H., McMurray, J. J., Francis, G. S., Henis, M., O'Connor, C. M., Diaz, R., Belenkov, Y. N., Varshavsky, S., Leimberger, J. D., Velazquez, E. J., Califf, R. M., & Pfeffer, M. A. (2004). Newly diagnosed and previously known diabetes mellitus and 1-year outcomes of acute myocardial infarction: the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. Circulation, 110(12), 1572-8.
Aguilar D, et al. Newly Diagnosed and Previously Known Diabetes Mellitus and 1-year Outcomes of Acute Myocardial Infarction: the VALsartan in Acute Myocardial iNfarcTion (VALIANT) Trial. Circulation. 2004 Sep 21;110(12):1572-8. PubMed PMID: 15364810.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Newly diagnosed and previously known diabetes mellitus and 1-year outcomes of acute myocardial infarction: the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. AU - Aguilar,David, AU - Solomon,Scott D, AU - Køber,Lars, AU - Rouleau,Jean-Lucien, AU - Skali,Hicham, AU - McMurray,John J V, AU - Francis,Gary S, AU - Henis,Marc, AU - O'Connor,Christopher M, AU - Diaz,Rafael, AU - Belenkov,Yuri N, AU - Varshavsky,Sergei, AU - Leimberger,Jeffrey D, AU - Velazquez,Eric J, AU - Califf,Robert M, AU - Pfeffer,Marc A, Y1 - 2004/09/13/ PY - 2004/9/15/pubmed PY - 2005/6/9/medline PY - 2004/9/15/entrez SP - 1572 EP - 8 JF - Circulation JO - Circulation VL - 110 IS - 12 N2 - BACKGROUND: A prior diagnosis of diabetes mellitus is associated with adverse outcomes after acute myocardial infarction (MI), but the risk associated with a new diagnosis of diabetes in this setting has not been well defined. METHODS AND RESULTS: We assessed the risk of death and major cardiovascular events associated with previously known and newly diagnosed diabetes by studying 14,703 patients with acute MI enrolled in the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. Patients were grouped by diabetic status: previously known diabetes (insulin use or diagnosis of diabetes before MI, n=3400, 23%); newly diagnosed diabetes (use of diabetic therapy or diabetes diagnosed at randomization [median 4.9 d after infarction], but no known diabetes at presentation, n=580, 4%); or no diabetes (n=10,719). Patients with newly diagnosed diabetes were younger and had fewer comorbid conditions than did patients with previously known diabetes. At 1 year after enrollment, patients with previously known and newly diagnosed diabetes had similarly increased adjusted risks of mortality (hazard ratio [HR] 1.43; 95% confidence interval [CI], 1.29 to 1.59 and HR, 1.50; 95% CI, 1.21 to 1.85, respectively) and cardiovascular events (HR, 1.37; 95% CI, 1.27 to 1.48 and HR, 1.34; 95% CI, 1.14 to 1.56). CONCLUSIONS: Diabetes mellitus, whether newly diagnosed or previously known, is associated with poorer long-term outcomes after MI in high-risk patients. The poor prognosis of patients with newly diagnosed diabetes, despite having baseline characteristics similar to those of patients without diabetes, supports the idea that metabolic abnormalities contribute to their adverse outcomes. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15364810/Newly_diagnosed_and_previously_known_diabetes_mellitus_and_1_year_outcomes_of_acute_myocardial_infarction:_the_VALsartan_In_Acute_myocardial_iNfarcTion__VALIANT__trial_ L2 - https://www.ahajournals.org/doi/10.1161/01.CIR.0000142047.28024.F2?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -