Diabetes is associated with worse long-term outcomes in young adults after myocardial infarction: The partners young-mi registry

Sanjay Divakaran, Avinainder Singh, David Biery, Junjie Yang, Ersilia M. Defilippis, Bradley L. Collins, Mattheus Ramsis, Arman Qamar, Jon Hainer, Josh Klein, Christopher P. Cannon, Donna M. Polk, Jorge Plutzky, Khurram Nasir, James L. Januzzi, Marcelo F. Di Carli, Deepak L. Bhatt, Ron Blankstein

Research output: Contribution to journalArticle

6 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1843-1850
Number of pages8
JournalDiabetes care
Volume43
Issue number8
DOIs
StatePublished - Aug 2020

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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