[Prognosis after myocardial infarct in a diabetic patient: results of coronary intensive care unit epidemiological study].
OBJECTIVE
Determine early and mid-term mortality in diabetic patients with myocardial infarction and ascertain whether diabetes is an independent prognosis factor.


METHODS
All patients admitted to an intensive care unit within 48 hours of the first signs of myocardial infarction were included in the study. Diabetic status was recorded at admission. Early mortality (5 day) and 1-year mortality was compared between diabetic and non-diabetic patients. Multivariate analysis was used to determine the predictive value of diabetic status as an independent factor.


RESULTS
2527 patients, including 440 diabetics (17%) and 2087 non-diabetics (83%) were followed at 5 days; 2125 patients, including 364 diabetics (17%) and 1761 non-diabetics (83%) were followed to 1 year. Diabetes was more frequent in older patients and in women. Mortality in diabetic patients was higher than in non-diabetics. At 5 days, mortality was 10.4% versus 17.6% (p < 0.001). Multivariate analysis did not confirm diabetic status as an independent risk factor for death at 5 days. Inversely, at 1 year, diabetic status was an independent risk factor (RR = 1.4; 95% CI = 1.1 -1.8; p = 0.004).


CONCLUSIONS
Diabetes is associated with poor prognosis after myocardial infarction. After correction for other risk factors, diabetes is an independent risk factor which must be taken into account when managien after myocardial infarction.
Genès
N
N
Laboratoires Roussel Diamant, Direction Médicale, Paris La Défense, HMR France.
Vaur
L
L
Dubroca
I
I
Etienne
S
S
Cambou
J P
JP
Danchin
N
N
D000368:Aged; D000369:Aged, 80 and over; D003325:Coronary Care Units; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors
Pronostic de l'infarctus du myocarde chez le patient diabétique: résultats de l'étude épidémiologique USIK.