Type 1 diabetes patients more likely to die after attack of myocardial infarction
Finland: After myocardial infarction, patients with type 1 diabetes face a higher risk of death compared to patients without diabetes, a research states. The findings of the study, published in the journal Diabetes Care, call for attention to vigorous prevention of cardiovascular disease in type 1 diabetes patients.
Type 1 diabetes is a known risk factor for myocardial infarction (MI). Anne M. Kerola, Faculty of Medicine, University of Helsinki, Helsinki, Finland, and colleagues conducted the study to evaluate the case fatality in patients with type 1 diabetes after MI.
For this purpose, the researchers studied consecutive patients experiencing MI with type 1 diabetes (n = 1,935; 41% female; mean age 62.5 years) and without diabetes (n = 74,671) who were admitted to 20 hospitals in Finland from 2005 to 2018 using national registries. Death within 1 year after MI was the outcome of interest. Multivariable adjustments and propensity score matching were used to balance differences between groups.
The findings of the study were as follows:
- Case fatality was higher in patients with type 1 diabetes than in propensity score-matched controls without diabetes at 30 days (12.8% vs. 8.5%) and at 1 year (24.3% vs. 16.8%) after MI (hazard ratio 1.55).
- Patients with type 1 diabetes had poorer prognoses in subgroups of men and women and of those with and without ST-elevation MI, with and without revascularization, with and without atrial fibrillation, and with and without heart failure.
- The relative fatality risk in type 1 diabetes was highest in younger patients.
- Older age, heart failure, peripheral vascular disease, renal failure, and no revascularization were associated with a worse prognosis after MI.
- The case fatality among patients with type 1 diabetes decreased during the study period, but outcome differences compared with patients without diabetes remained similar.
"Type 1 diabetes patients are at higher risk of death after MI than those without diabetes," wrote the authors. "Our findings call for attention to vigorous cardiovascular disease prevention in patients with type 1 diabetes."
Reference:
Anne M. Kerola, Markus Juonala, Antti Palomäki, Anne Grete Semb, Päivi Rautava, Ville Kytö; Case Fatality of Patients With Type 1 Diabetes After Myocardial Infarction. Diabetes Care 2022; dc220042.https://doi.org/10.2337/dc22-0042
