title: Mortality after first myocardial infarction in diabetic and non-diabetic people between 1985 and 2009. The MONICA/KORA registry.
abstract: The aim of the study was to analyse mortality after a first myocardial infarction (MI) and its trends in people with diabetes compared to those without diabetes in Southern Germany, 1985-2009. Using data of the population-based MONICA/KORA Myocardial Infarction Registry, we ascertained all patients with a first fatal or non-fatal MI between 1985 and 2009 (n = 16,478, age 25-74 years, 71% male, 29% with diabetes). The impact of diabetes and calendar time on mortality was examined using multiple logistic and Cox regression. Survival improved with calendar time: The crude cumulative 5-year survival was 26.9 and 46.3% among diabetic and non-diabetic individuals (both sexes combined) with a first MI in the years 1985-1989, and 53.6 and 66.6% among those with a first MI in the years 2005-2009. This significant decrease of mortality was confirmed in multivariate analyses. The proportion of fatal first MIs was significantly higher in diabetic compared to non-diabetic patients [adjusted odds ratio (OR) 1.26; 95% confidence interval 1.17-1.36]. This association persisted in a similar manner between both sexes with no consistent change of OR over calendar time in which first MIs have been observed. Likewise, multiple adjusted risk of death after a non-fatal first MI was significantly higher among both diabetic men and women [hazard ratio (HR) 1.64; 1.47-1.82, 1.83; 1.55-2.14] with constant HR over calendar time. During the past 25 years, survival has improved in both diabetic and non-diabetic patients with incident MI in a similar manner. However, mortality after a first MI remained significantly higher in the diabetic population, particularly in women.
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Centre, Leibniz-Centre for Diabetes Research, Heinrich-Heine-University, Düsseldorf, Germany, andrea.icks@ddz.uni-duesseldorf.de.
authors.forename: Andrea
authors.initials: A
authors.lastname: Icks
authors.forename: Heiner
authors.initials: H
authors.lastname: Claessen
authors.forename: Inge
authors.initials: I
authors.lastname: Kirchberger
authors.forename: Margit
authors.initials: M
authors.lastname: Heier
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.forename: Ines
authors.initials: I
authors.lastname: Trentinaglia
authors.forename: Guido
authors.initials: G
authors.lastname: Giani
authors.forename: Wolfgang
authors.initials: W
authors.lastname: von Scheidt
authors.forename: Christa
authors.initials: C
authors.lastname: Meisinger
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death / Q000639:trends; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000401:mortality; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality*; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors