Aim: To define the predictors of long-term mortality in patients with type 2 diabetes mellitus and recent acute coronary syndrome. Methods and results: A total of 7226 patients from a randomized trial, testing the effect on cardiovascular outcomes of the dual peroxisome proliferator–activated receptor agonist aleglitazar in patients with type 2 diabetes mellitus and recent acute coronary syndrome (AleCardio trial), were analysed. Median follow-up was 2 years. The independent mortality predictors were defined using Cox regression analysis. The predictive information provided by each variable was calculated as percent of total chi-square of the model. All-cause mortality was 4.0%, with cardiovascular death contributing for 73% of mortality. The mortality prediction model included N-terminal proB-type natriuretic peptide (adjusted hazard ratio = 1.68; 95% confidence interval = 1.51–1.88; 27% of prediction), lack of coronary revascularization (hazard ratio = 2.28; 95% confidence interval = 1.77–2.93; 18% of prediction), age (hazard ratio = 1.04; 95% confidence interval = 1.02–1.05; 15% of prediction), heart rate (hazard ratio = 1.02; 95% confidence interval = 1.01–1.03; 10% of prediction), glycated haemoglobin (hazard ratio = 1.11; 95% confidence interval = 1.03–1.19; 8% of prediction), haemoglobin (hazard ratio = 1.01; 95% confidence interval = 1.00–1.02; 8% of prediction), prior coronary artery bypass (hazard ratio = 1.61; 95% confidence interval = 1.11–2.32; 7% of prediction) and prior myocardial infarction (hazard ratio = 1.40; 95% confidence interval = 1.05–1.87; 6% of prediction). Conclusion: In patients with type 2 diabetes mellitus and recent acute coronary syndrome, mortality prediction is largely dominated by markers of cardiac, rather than metabolic, dysfunction.

Predictors of mortality in hospital survivors with type 2 diabetes mellitus and acute coronary syndromes / Savonitto, S; Morici, N; Nozza, A; Cosentino, F; Perrone Filardi, P; Murena, E; Morocutti, G; Ferri, M; Cavallini, C; Eijkemans, Mj; Stähli, Be; Schrieks, Ic; Toyama, T; Lambers Heerspink, Hj; Malmberg, K; Schwartz, Gg; Lincoff, Am; Ryden, L; Tardif, Jc; Grobbee, De. - In: DIABETES & VASCULAR DISEASE RESEARCH. - ISSN 1479-1641. - STAMPA. - 15:1(2018), pp. 14-23. [10.1177/1479164117735493]

Predictors of mortality in hospital survivors with type 2 diabetes mellitus and acute coronary syndromes

Cosentino F;
2018

Abstract

Aim: To define the predictors of long-term mortality in patients with type 2 diabetes mellitus and recent acute coronary syndrome. Methods and results: A total of 7226 patients from a randomized trial, testing the effect on cardiovascular outcomes of the dual peroxisome proliferator–activated receptor agonist aleglitazar in patients with type 2 diabetes mellitus and recent acute coronary syndrome (AleCardio trial), were analysed. Median follow-up was 2 years. The independent mortality predictors were defined using Cox regression analysis. The predictive information provided by each variable was calculated as percent of total chi-square of the model. All-cause mortality was 4.0%, with cardiovascular death contributing for 73% of mortality. The mortality prediction model included N-terminal proB-type natriuretic peptide (adjusted hazard ratio = 1.68; 95% confidence interval = 1.51–1.88; 27% of prediction), lack of coronary revascularization (hazard ratio = 2.28; 95% confidence interval = 1.77–2.93; 18% of prediction), age (hazard ratio = 1.04; 95% confidence interval = 1.02–1.05; 15% of prediction), heart rate (hazard ratio = 1.02; 95% confidence interval = 1.01–1.03; 10% of prediction), glycated haemoglobin (hazard ratio = 1.11; 95% confidence interval = 1.03–1.19; 8% of prediction), haemoglobin (hazard ratio = 1.01; 95% confidence interval = 1.00–1.02; 8% of prediction), prior coronary artery bypass (hazard ratio = 1.61; 95% confidence interval = 1.11–2.32; 7% of prediction) and prior myocardial infarction (hazard ratio = 1.40; 95% confidence interval = 1.05–1.87; 6% of prediction). Conclusion: In patients with type 2 diabetes mellitus and recent acute coronary syndrome, mortality prediction is largely dominated by markers of cardiac, rather than metabolic, dysfunction.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1088601
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