@article{7f9815dcd7224a01b808350ae8a8c9ca,
title = "Diabetes is associated with worse long-term outcomes in young adults after myocardial infarction: The partners young-mi registry",
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 A1c ≥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.",
author = "Sanjay Divakaran and Avinainder Singh and David Biery and Junjie Yang and Defilippis, {Ersilia M.} and Collins, {Bradley L.} and Mattheus Ramsis and Arman Qamar and Jon Hainer and Josh Klein and Cannon, {Christopher P.} and Polk, {Donna M.} and Jorge Plutzky and Khurram Nasir and Januzzi, {James L.} and {Di Carli}, {Marcelo F.} and Bhatt, {Deepak L.} and Ron Blankstein",
note = "Funding Information: S.D. and A.Q. are supported by T32 postdoctoral training grants from the National Heart, Lung, and Blood Institute (T32-HL-094301 and T32-HL-007604, respectively). J.L.J. is supported in part by the Hutter Family Professorship. Funding Information: Funding. S.D. and A.Q. are supported by T32 postdoctoral training grants from the National Heart, Lung, and Blood Institute (T32-HL-094301 andT32-HL-007604, respectively). J.L.J. is sup-portedinpartbytheHutterFamilyProfessorship. Duality of Interest C.P.C. reports research grants from Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Janssen, and Merck and consulting fees from Alnylam, Amarin, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Eisai, Janssen, Kowa, Merck, Pfizer, Regeneron, and Sanofi. J.P. reports serving as a consultant for Aegerion, Amgen, Merck, Novartis, Novo Nordisk, Pfizer, Sanofi, and Vivus. J.L.J. has received grant support from Roche Diagnostics, Abbott Diagnostics, Singulex, Pre-vencio, and Cleveland Heart Laboratories; has received consulting income from Roche Diagnostics, MyoKardia, Abbott, and Critical Diagnostics; and has participated in clinical end point committees/data safety monitoring boards for Boehringer Ingelheim, Amgen, AbbVie, Janssen, Abbott, and Siemens Diagnostics. M.F.D.C. has received consulting fees from Sanofi and General Electric. D.L.B. discloses the following relationships: advisory boards for Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, and Regado Biosciences; board of directors for Boston VA Research Institute, Society of Cardiovascular Patient Care, and TOBESOFT; chair of the American Heart Association Quality Oversight Committee; data monitoring committees for Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the Portopulmonary Hypertension Treatment with Macitentan [PORTICO trial], funded by St. Jude Medical, now Abbott), Cleveland Clinic (including for the CENTERA THV System in Intermediate Risk Patients Who Have Symptomatic, Severe, Calcific, Aortic Stenosis Requiring Aortic Valve Replacement [ExCEED trial], funded by Edwards), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the Edoxaban Compared to Standard Care After Heart Valve Replacement [ENVISAGE] trial, funded by Daiichi Sankyo), and Population Health Research Institute;honorariafromtheAmericanCollegeof Cardiology (ACC) (senior associate editor, Clinical Trials and News and ACC.org, and vice-chair, ACC Accreditation Committee), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the Triple Therapy With Warfarin in Patients With Nonvalvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention [RE-DUAL PCI] clinical trial steering committee, funded by Boehringer Ingelheim), Belvoir Publications (editor in chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees), HMP Global (editor in chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (guest editor, associate editor), Population Health Research Institute (for the Cardiovascular Outcomes for People Using Anticoagulation Strategies [COMPASS] Operations Committee, Publications Committee, and Steering Committee, and U.S. national co-leader, funded by Bayer), Slack Publications (chief medical editor, Cardiology Today{\textquoteright}s Intervention), Society of Cardiovascular Patient Care (secretary/treasurer), and WebMD (continuing medical education steering committees); other relationships with Clinical Cardiology (deputy editor), NCDR-ACTION Registry Steering Committee (chair), and Veterans Administration Clinical Assessment, Reporting and Tracking System for Cath Labs [VA CART] Research and Publications Committee (chair); research funding from Abbott, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingel-heim, Bristol-Myers Squibb, Chiesi, Eisai, Ethicon, Forest Laboratories, Idorsia, Ironwood, Ischemix, Lilly, Medtronic, PhaseBio, Pfizer, Regeneron, Roche, Sanofi Aventis, Synaptic, and The Medicines Company; royalties from Elsevier (editor, Cardiovascular Intervention: A Companion to Braunwald{\textquoteright}s Heart Disease); site co-investigator for Biotronik, Boston Scientific, St. Jude Medical (now Abbott), and Svelte; trustee for the ACC; and unfunded research for FlowCo, Fractyl, Merck, Novo Nordisk, PLx Pharma, and Takeda. No other potential conflicts of interest relevant to this article were reported. Author Contributions. S.D., A.S., D.B., B.L.C., D.L.B., and R.B. researched the data and wrote the manuscript. J.Y., E.M.D., M.R., A.Q., J.H., and J.K. researched the data and reviewed/edited the manuscript. C.P.C., D.M.P., J.P., K.N., J.L.J., and M.F.D.C. reviewed/edited the manuscript. S.D. and R.B. are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Prior Presentation. Parts of this study were published in abstract form at the 68th Annual Scientific Session and Expo of the American College of Cardiology, New Orleans, LA, 16–18 March 2019. Publisher Copyright: {\textcopyright} 2019 by the American Diabetes Association.",
year = "2020",
month = aug,
doi = "10.2337/dc19-0998",
language = "English (US)",
volume = "43",
pages = "1843--1850",
journal = "Diabetes care",
issn = "0149-5992",
publisher = "American Diabetes Association Inc.",
number = "8",
}