title: Acute Myocardial Infarction Is a Risk Factor for New Onset Diabetes in Patients with Coronary Artery Disease.
abstract: OBJECTIVE
  To test the hypothesis that acute myocardial infarction (AMI) might accelerate development of new onset diabetes in patients with coronary artery disease independent of known risk factors.
  
  
  METHODS
  We conducted a retrospective cohort study within COACT (CathOlic medical center percutAneous Coronary inTervention) registry. From a total of 9,127 subjects, 2,036 subjects were diabetes naïve and followed up for at least one year with both index and follow-up laboratory data about diabetes. Cox proportional hazard model was used to derive hazard ratios (HRs) and 95% confidence interval (CI) for new onset diabetes associated with AMI in univariate and multivariate analysis after adjusting several covariates.
  
  
  RESULTS
  The overall hazard for diabetes was higher in AMI compared to non-AMI patients (p by log rank <0.01) with HR of 1.78 and 95% CI of 1.37-2.32 in univariate analysis. This association remained significant after adjusting covariates (HR, 1.54; 95% CI, 1.14-2.07; p<0.01). AMI was an independent predictor for higher quartile of WBC count in multivariate ordinal logistic regression analysis (OR, 6.75; 95% CI, 5.53-8.22, p<0.01). In subgroup analysis, the diabetogenic effect of AMI was more prominent in the subgroup without MetS compared to MetS patients (p for interaction<0.05). Compared to the reference group of non-AMI+nonMetS, the group of AMI+non-MetS (HR, 2.44; 95% CI, 1.58-3.76), non-AMI+MetS (HR, 3.42; 95% CI, 2.34-4.98) and AMI+MetS (HR, 4.12; 95% CI, 2.67-6.36) showed higher HR after adjusting covariates. However, the hazard was not different between the non-AMI+MetS and AMI+non-MetS groups.
  
  
  CONCLUSIONS
  AMI patients have a greater risk of new-onset diabetes when compared to non AMI patients, especially those with mild metabolic abnormalities.
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cardiovascular Center and Cardiology Division, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors: Chul Soo
authors: CS
authors: Park
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cardiovascular Center and Cardiology Division, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors: Woo Baek
authors: WB
authors: Chung
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cardiovascular Center and Cardiology Division, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors: Yun Seok
authors: YS
authors: Choi
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cardiovascular Center and Cardiology Division, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea.
authors: Pum Joon
authors: PJ
authors: Kim
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cardiovascular Center and Cardiology Division, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea.
authors: Jong Min
authors: JM
authors: Lee
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors: Ki-Hyun
authors: KH
authors: Baek
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cardiovascular Center and Cardiology Division, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Republic of Korea.
authors: Hee Yeol
authors: HY
authors: Kim
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cardiovascular Center and Cardiology Division, St. Vincent Hospital, The Catholic University of Korea, Suwon, Republic of Korea.
authors: Ki Dong
authors: KD
authors: Yoo
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors: Ki-Ho
authors: KH
authors: Song
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cardiovascular Center and Cardiology Division, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea.
authors: Wook Sung
authors: WS
authors: Chung
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cardiovascular Center and Cardiology Division, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea.
authors: Ki Bae
authors: KB
authors: Seung
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cardiovascular Center and Cardiology Division, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors: Man Young
authors: MY
authors: Lee
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors: Hyuk-Sang
authors: HS
authors: Kwon
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors