Clinical characteristics and prognostic implications of diabetes and myocardial injury in patients admitted to the emergency room.

Autor: Bonet G; Department of Cardiology, Joan XXIII University Hospital, Calle Dr Mallafré Guash 4, 43005, Tarragona, Spain.; Pere Virgili Health Research Institute (IISPV), Tarragona, Spain.; Rovira I Virgili University, Tarragona, Spain., Carrasquer A; Department of Cardiology, Joan XXIII University Hospital, Calle Dr Mallafré Guash 4, 43005, Tarragona, Spain.; Pere Virgili Health Research Institute (IISPV), Tarragona, Spain.; Rovira I Virgili University, Tarragona, Spain., Peiró ÓM; Department of Cardiology, Joan XXIII University Hospital, Calle Dr Mallafré Guash 4, 43005, Tarragona, Spain.; Pere Virgili Health Research Institute (IISPV), Tarragona, Spain.; Rovira I Virgili University, Tarragona, Spain., Sanchez-Gimenez R; Department of Cardiology, Joan XXIII University Hospital, Calle Dr Mallafré Guash 4, 43005, Tarragona, Spain.; Pere Virgili Health Research Institute (IISPV), Tarragona, Spain.; Rovira I Virgili University, Tarragona, Spain., Lal-Trehan N; Department of Cardiology, Joan XXIII University Hospital, Calle Dr Mallafré Guash 4, 43005, Tarragona, Spain.; Pere Virgili Health Research Institute (IISPV), Tarragona, Spain.; Rovira I Virgili University, Tarragona, Spain., Del-Moral-Ronda V; Department of Cardiology, Joan XXIII University Hospital, Calle Dr Mallafré Guash 4, 43005, Tarragona, Spain.; Pere Virgili Health Research Institute (IISPV), Tarragona, Spain.; Rovira I Virgili University, Tarragona, Spain., Fort-Gallifa I; Clinical Laboratory, Catalan Institute of Health, Camp de Tarragona-Terres de L'Ebre, Tarragona, Spain., Bardají A; Department of Cardiology, Joan XXIII University Hospital, Calle Dr Mallafré Guash 4, 43005, Tarragona, Spain. alfredo.bardaji@urv.cat.; Pere Virgili Health Research Institute (IISPV), Tarragona, Spain. alfredo.bardaji@urv.cat.; Rovira I Virgili University, Tarragona, Spain. alfredo.bardaji@urv.cat.
Jazyk: angličtina
Zdroj: BMC cardiovascular disorders [BMC Cardiovasc Disord] 2021 Aug 30; Vol. 21 (1), pp. 414. Date of Electronic Publication: 2021 Aug 30.
DOI: 10.1186/s12872-021-02220-1
Abstrakt: Background: This study aimed to investigate the clinical features and prognosis of diabetes and myocardial injury in patients admitted to the emergency department.
Methods: We analyzed the clinical data of all consecutive patients admitted to the emergency department during the years 2012 and 2013 with at least 1 cardiac Troponin I (cTnI Ultra Siemens, Advia Centaur) determination, and were classified according to the status of diabetes mellitus (DM) and myocardial injury (MI). Clinical events were evaluated in a 4-year follow-up.
Results: A total of 3622 patients were classified according to the presence of DM (n = 924 (25.55%)) and MI (n = 1049 (28.96%)). The proportion of MI in patients with DM was 40% and 25% in patients without DM. Mortality during follow-up was 10.9% in non-DM patients without MI, 21.3% in DM patients without MI, 40.1% in non-DM patients with MI, and 52.8% in DM patients with MI. A competitive risk model was used to obtain the Hazard Ratio (HR) for readmission for myocardial infarction or heart failure. There was a similar proportion of readmission for myocardial infarction and heart failure at a four-year follow-up in patients with DM or MI, which was much higher when DM was associated with MI, with respect to patients without DM or MI. The HR (95% Coefficient Interval) for myocardial infarction in the DM without MI, non-DM with MI, and DM with MI groups with respect to the non-DM without MI group was 2511 (1592-3960), 2682 (1739-4138), and 5036 (3221-7876), respectively. The HR (95% CI) for the risk of readmission for heart failure in the DM without MI, non-DM with MI, and DM with MI groups with respect to the non-DM without MI group was 2663 (1825-3886), 2562 (1753-3744) and 4292 (2936-6274), respectively.
Conclusions: The association of DM and MI in patients treated in an Emergency Service identifies patients at very high risk of mortality and cardiovascular events.
(© 2021. The Author(s).)
Databáze: MEDLINE
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