title: Sustained prognostic implications of newly detected glucose abnormalities in patients with acute myocardial infarction: long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort.
abstract: OBJECTIVE
  To investigate long-term prognostic importance of newly discovered glucose disturbances in patients with acute myocardial infarction (AMI).
  
  
  METHODS
  During 1998-2001, consecutive patients with AMI (n = 167) and healthy controls (n = 184) with no previously known diabetes were investigated with an oral glucose tolerance test (OGTT). Patients and controls were separately followed up for cardiovascular events (first of cardiovascular mortality/AMI/stroke/heart failure) during a decade.
  
  
  RESULTS
  In all, 68% of the patients and 35% of the controls had newly detected abnormal glucose tolerance (AGT). Cardiovascular event (n = 72, p = 0.0019) and cardiovascular mortality (n = 31, p = 0.031) were more frequent in patients with newly detected AGT. Regarding patients, a Cox proportional-hazard regression analysis identified AGT (hazard ratio (HR): 2.30; 95% confidence interval (CI): 1.24-4.25; p = 0.008) and previous AMI (HR: 2.39; CI: 1.31-4.35; p = 0.004) as prognostically important.
  
  
  CONCLUSIONS
  An OGTT at discharge after AMI disclosed a high proportion of patients with previously unknown AGT which had a significant and independent association with long-term prognosis.
authors.affiliation: Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden Unit for Research and Development Kronoberg County Council, Växjö, Sweden viveca.ritsinger@ki.se.
authors.forename: Viveca
authors.initials: V
authors.lastname: Ritsinger
authors.affiliation: Department of Medicine and Centre for Clinical Research, Central Hospital Västerås, Västerås, Sweden.
authors.forename: Eleni
authors.initials: E
authors.lastname: Tanoglidi
authors.affiliation: Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Klas
authors.initials: K
authors.lastname: Malmberg
authors.affiliation: Centre for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Näsman
authors.affiliation: Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Rydén
authors.affiliation: Department of Medicine and Centre for Clinical Research, Central Hospital Västerås, Västerås, Sweden.
authors.forename: Åke
authors.initials: Å
authors.lastname: Tenerz
authors.affiliation: Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Norhammar
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis*; D058065:Diabetic Cardiomyopathies / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000150:complications / Q000175:diagnosis*; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D010351:Patient Discharge; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology
keywords: Myocardial infarction; diabetes; impaired glucose tolerance; oral glucose tolerance test; prognosis