Haptoglobin polymorphism predicts 30-day mortality and heart failure in patients with diabetes and acute myocardial infarction.
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.
Suleiman
Mahmoud
M
Technion Faculty of Medicine, Rappaport Building, Bat Galim, Haifa, 31096, Israel.
Aronson
Doron
D
Asleh
Rabea
R
Kapeliovich
Michael R
MR
Roguin
Ariel
A
Meisel
Simcha R
SR
Shochat
Michael
M
Sulieman
Abeer
A
Reisner
Shimon A
SA
Markiewicz
Walter
W
Hammerman
Haim
H
Lotan
Rachel
R
Levy
Nina S
NS
Levy
Andrew P
AP
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
D006242:Haptoglobins