Abstract
OBJECTIVE: We sought to determine the prevalence of diabetes and associated cardiovascular outcomes in a contemporary cohort of young individuals presenting with their first myocardial infarction (MI) at age ≤50 years.
RESEARCH DESIGN AND METHODS: We retrospectively analyzed records of patients presenting with a first type 1 MI at age ≤50 years from 2000 to 2016. Diabetes was defined as a hemoglobin A 1c ≥6.5% (48 mmol/mol) or a documented diagnosis of or treatment for diabetes. Vital status was ascertained for all patients, and cause of death was adjudicated.
RESULTS: Among 2,097 young patients who had a type 1 MI (mean age 44.0 ± 5.1 years, 19.3% female, 73% white), diabetes was present in 416 (20%), of whom 172 (41%) were receiving insulin. Over a median follow-up of 11.2 years (interquartile range 7.3-14.2 years), diabetes was associated with a higher all-cause mortality (hazard ratio 2.30; P < 0.001) and cardiovascular mortality (2.68; P < 0.001). These associations persisted after adjusting for baseline covariates (all-cause mortality: 1.65; P = 0.008; cardiovascular mortality: 2.10; P = 0.004).
CONCLUSIONS: Diabetes was present in 20% of patients who presented with their first MI at age ≤50 years and was associated with worse long-term all-cause and cardiovascular mortality. These findings highlight the need for implementing more aggressive therapies aimed at preventing future adverse cardiovascular events in this population.
Original language | English (US) |
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Pages (from-to) | 1843-1850 |
Number of pages | 8 |
Journal | Diabetes care |
Volume | 43 |
Issue number | 8 |
DOIs | |
State | Published - Aug 2020 |
Keywords
- Adult
- Age Factors
- Aged
- Cohort Studies
- Diabetes Mellitus/diagnosis
- Diabetic Angiopathies/diagnosis
- Female
- Humans
- Male
- Middle Aged
- Myocardial Infarction/complications
- Prognosis
- Registries
- Retrospective Studies
- Risk Factors
- Time Factors
- United States/epidemiology
- Young Adult
ASJC Scopus subject areas
- Advanced and Specialized Nursing
- Internal Medicine
- Endocrinology, Diabetes and Metabolism