title: Long-term prognostic importance of diabetes after a myocardial infarction depends on left ventricular systolic function.
abstract: OBJECTIVE
  This study was performed to understand how left ventricular function modulates the prognostic importance of diabetes after myocardial infarction (MI).
  
  
  METHODS
  Consecutively hospitalized MI patients screened for three clinical trials were followed for a median of 7 years. Multivariable Cox regression models were used to assess the risk of mortality associated with diabetes, and the importance of diabetes was examined independently within defined left ventricular ejection fraction (LVEF) subgroups.
  
  
  RESULTS
  A total of 16,912 patients were included; 1,819 (11%) had diabetes. Diabetes and 15% unit depression in LVEF were of similar prognostic importance: hazard ratios (HRs) were 1.45 (95% CI 1.37-1.54) and 1.41 (1.37-1.45) for diabetes and LVEF depression, respectively. LVEF modified the outcomes associated with diabetes, with HRs being 1.29 (1.19-1.40) and 1.61 (1.49-1.74) in patients with LVEF <40% and LVEF ≥ 40%, respectively (P = 0.03).
  
  
  CONCLUSIONS
  Patients within the higher LVEF categories have a greater mortality risk attributable to diabetes than patients within the lower LVEF categories.
authors.affiliation: Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark. ca@heart.dk
authors.forename: Charlotte
authors.initials: C
authors.lastname: Andersson
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Gislason
authors.forename: Charlotte
authors.initials: C
authors.lastname: Mérie
authors.forename: Ulrik M
authors.initials: UM
authors.lastname: Mogensen
authors.forename: Scott D
authors.initials: SD
authors.lastname: Solomon
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D016016:Proportional Hazards Models; D016277:Ventricular Function, Left / Q000502:physiology*