title: Haptoglobin polymorphism predicts 30-day mortality and heart failure in patients with diabetes and acute myocardial infarction.
abstract: Patients with diabetes presenting with acute myocardial infarction (AMI) have an increased rate of death and heart failure. Patients with diabetes homozygous for the haptoglobin (Hp) 1 allele (Hp 1-1) develop fewer vascular complications. We tested the hypothesis that Hp type is related to the outcome of patients with diabetes presenting with AMI. We prospectively assessed the relationship between Hp type and 30-day mortality and heart failure in 1,437 patients with AMI (506 with diabetes). Multivariate logistic regression identified a significant interaction between Hp type and diabetes status on these outcome measures. Hp type was not related to outcome among patients without diabetes. In contrast, Hp 1-1 was associated with a strong protective effect with regard to the primary end point of death (OR 0.14, P = 0.015) and for death and heart failure (OR 0.35; 95% CI 0.15-0.86, P = 0.018) among patients with diabetes. Finally, among patients with diabetes, Hp 1-1 was associated with smaller infarct size. This study demonstrates that in patients with diabetes and AMI, the Hp type is an important determinant of clinical outcome and infarct size.
authors.affiliation: Technion Faculty of Medicine, Rappaport Building, Bat Galim, Haifa, 31096, Israel.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Suleiman
authors.forename: Doron
authors.initials: D
authors.lastname: Aronson
authors.forename: Rabea
authors.initials: R
authors.lastname: Asleh
authors.forename: Michael R
authors.initials: MR
authors.lastname: Kapeliovich
authors.forename: Ariel
authors.initials: A
authors.lastname: Roguin
authors.forename: Simcha R
authors.initials: SR
authors.lastname: Meisel
authors.forename: Michael
authors.initials: M
authors.lastname: Shochat
authors.forename: Abeer
authors.initials: A
authors.lastname: Sulieman
authors.forename: Shimon A
authors.initials: SA
authors.lastname: Reisner
authors.forename: Walter
authors.initials: W
authors.lastname: Markiewicz
authors.forename: Haim
authors.initials: H
authors.lastname: Hammerman
authors.forename: Rachel
authors.initials: R
authors.lastname: Lotan
authors.forename: Nina S
authors.initials: NS
authors.lastname: Levy
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Levy
mesh_terms: D003920:Diabetes Mellitus / Q000503:physiopathology*; D005838:Genotype; D006242:Haptoglobins / Q000235:genetics*; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000235:genetics* / Q000401:mortality*; D016017:Odds Ratio; D010641:Phenotype; D011110:Polymorphism, Genetic; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D006242:Haptoglobins