Comparison of clinical outcomes following acute myocardial infarctions in hypertensive patients with or without diabetes

Goo Lee Min, Ho Jeong Myung, Youngkeun Ahn, Chull Chae Shung, Ho Hur Seung, Jong Hong Taek, Jo Kim Young, Whan Seong In, Keon Chae Jei, Young Rhew Jay, Ho Chae In, Chan Cho Myeong, Ho Bae Jang, Seung-Woon Rha, Jim Kim Chong, Donghoon Choi, Soo Jang Yang, Junghan Yoon, Sung Chung Wook, Gwan Cho Jeong & 37 others Bae Seung Ki, Jung Park Seung, Hyun Kim Jong, Young Rhew Jae, Il Kim Doo, Han Yoon Jung, Kwon Koo Bon, Ok Kim Byung, Yong Lee Myoung, Sik Kim Kee, Young Hwang Jin, Kyu Oh Seok, Hee Lee Nae, Tae Jeong Kyoung, Lea Tahk Seung, Soo Park Keum, Rok Han Kyoo, Hoon Ahn Tae, Hyun Kim Moo, Young Yang Ju, Yun Rhim Chong, Cheol Gwon Hyeon, Wook Park Seong, Youp Koh Young, Jae Joo Seung, Bong Kim Soo, Kyu Jin Dong, Man Cho Jin, Sang Wook Kim, Kyung Kim Jeong, Ik Kim Tae, Young Nah Deug, Hoon Park Si, Hyun Lee Sang, Hang Jae Chung, Hyun Cho Jang, Won Jin Seung

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background and Objectives: It is thought that patients with diabetes mellitus (DM) have a poor prognosis after an acute myocardial infarction (AMI), but the effect of diabetes on the outcomes of hypertensive patients with AMIs has not been elucidated in the Korean population. The aim of this study was to investigate the effects of diabetes on long-term clinical outcomes following AMIs in patients with hypertension. Subjects and Methods: Using data from the Korea Acute Myocardial Infarction Registry (November 2005 to December 2006), 2,233 hypertensive patients with AMIs were grouped as follows based on the presence of DM: group I, diabetic hypertension (n=892, 544 men, mean age=66.2±10.9 years); and group II, non-diabetic hypertension (n=1341, 938 men, mean age=63.9±12.8 years). The primary study outcomes included in-hospital death and major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), repeat percutaneous coronary intervention, and coronary artery bypass surgery) at the 1 year follow-up. Results: Hypertensive patients with DM were older and more likely to be women. The diabetic group had lower blood pressure (p<0.001), a lower left ventricular ejection fraction (p<0.001), a more severe degree of heart failure (p<0.001), a longer duration of coronary care unit admission (p<0.001), and a higher incidence of hyperlipidemia (p=0.007). The N-terminal pro-brain natriuretic peptide level (4602.5±8710.6 pg/mL vs. 2320.8±5837.9 pg/mL, p<0.001) was higher and the creatinine clearance (62.4±29.9 mL/min vs. 73.0±40.8 mL/min, p<0.001) was lower in the diabetic group than the non-diabetic group. Coronary angiographic findings revealed more frequent involvement of the left main stem (p=0.002) and multiple vessels (p<0.001) in the diabetic group. The rate of in-hospital death was higher in the diabetic group (p<0.001). During follow-up, the rates of composite MACE at 1 month, 6 months, and 12 months were higher in the diabetic group (p<0.001). Conclusion: In hypertensive patients with AMI, DM was associated with worse clinical and angiographic features, with a higher risk of development of severe heart failure, and an increased risk of MACE on long-term clinical follow-up.

Original languageEnglish
Pages (from-to)243-250
Number of pages8
JournalKorean Circulation Journal
Volume39
Issue number6
DOIs
Publication statusPublished - 2009 Jun 1

Fingerprint

Myocardial Infarction
Diabetes Mellitus
Hypertension
Heart Failure
Coronary Care Units
Brain Natriuretic Peptide
Percutaneous Coronary Intervention
Korea
Hyperlipidemias
Coronary Artery Bypass
Stroke Volume
Registries
Creatinine
Outcome Assessment (Health Care)
Blood Pressure
Incidence
Population

Keywords

  • Diabetes mellitus
  • Hypertension
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

Cite this

Comparison of clinical outcomes following acute myocardial infarctions in hypertensive patients with or without diabetes. / Min, Goo Lee; Myung, Ho Jeong; Ahn, Youngkeun; Shung, Chull Chae; Seung, Ho Hur; Taek, Jong Hong; Young, Jo Kim; In, Whan Seong; Jei, Keon Chae; Jay, Young Rhew; In, Ho Chae; Myeong, Chan Cho; Jang, Ho Bae; Rha, Seung-Woon; Chong, Jim Kim; Choi, Donghoon; Yang, Soo Jang; Yoon, Junghan; Wook, Sung Chung; Jeong, Gwan Cho; Ki, Bae Seung; Seung, Jung Park; Jong, Hyun Kim; Jae, Young Rhew; Doo, Il Kim; Jung, Han Yoon; Bon, Kwon Koo; Byung, Ok Kim; Myoung, Yong Lee; Kee, Sik Kim; Jin, Young Hwang; Seok, Kyu Oh; Nae, Hee Lee; Kyoung, Tae Jeong; Seung, Lea Tahk; Keum, Soo Park; Kyoo, Rok Han; Tae, Hoon Ahn; Moo, Hyun Kim; Ju, Young Yang; Chong, Yun Rhim; Hyeon, Cheol Gwon; Seong, Wook Park; Young, Youp Koh; Seung, Jae Joo; Soo, Bong Kim; Dong, Kyu Jin; Jin, Man Cho; Kim, Sang Wook; Jeong, Kyung Kim; Tae, Ik Kim; Deug, Young Nah; Si, Hoon Park; Sang, Hyun Lee; Chung, Hang Jae; Jang, Hyun Cho; Seung, Won Jin.

In: Korean Circulation Journal, Vol. 39, No. 6, 01.06.2009, p. 243-250.

Research output: Contribution to journalArticle

Min, GL, Myung, HJ, Ahn, Y, Shung, CC, Seung, HH, Taek, JH, Young, JK, In, WS, Jei, KC, Jay, YR, In, HC, Myeong, CC, Jang, HB, Rha, S-W, Chong, JK, Choi, D, Yang, SJ, Yoon, J, Wook, SC, Jeong, GC, Ki, BS, Seung, JP, Jong, HK, Jae, YR, Doo, IK, Jung, HY, Bon, KK, Byung, OK, Myoung, YL, Kee, SK, Jin, YH, Seok, KO, Nae, HL, Kyoung, TJ, Seung, LT, Keum, SP, Kyoo, RH, Tae, HA, Moo, HK, Ju, YY, Chong, YR, Hyeon, CG, Seong, WP, Young, YK, Seung, JJ, Soo, BK, Dong, KJ, Jin, MC, Kim, SW, Jeong, KK, Tae, IK, Deug, YN, Si, HP, Sang, HL, Chung, HJ, Jang, HC & Seung, WJ 2009, 'Comparison of clinical outcomes following acute myocardial infarctions in hypertensive patients with or without diabetes', Korean Circulation Journal, vol. 39, no. 6, pp. 243-250. https://doi.org/10.4070/kcj.2009.39.6.243
Min, Goo Lee ; Myung, Ho Jeong ; Ahn, Youngkeun ; Shung, Chull Chae ; Seung, Ho Hur ; Taek, Jong Hong ; Young, Jo Kim ; In, Whan Seong ; Jei, Keon Chae ; Jay, Young Rhew ; In, Ho Chae ; Myeong, Chan Cho ; Jang, Ho Bae ; Rha, Seung-Woon ; Chong, Jim Kim ; Choi, Donghoon ; Yang, Soo Jang ; Yoon, Junghan ; Wook, Sung Chung ; Jeong, Gwan Cho ; Ki, Bae Seung ; Seung, Jung Park ; Jong, Hyun Kim ; Jae, Young Rhew ; Doo, Il Kim ; Jung, Han Yoon ; Bon, Kwon Koo ; Byung, Ok Kim ; Myoung, Yong Lee ; Kee, Sik Kim ; Jin, Young Hwang ; Seok, Kyu Oh ; Nae, Hee Lee ; Kyoung, Tae Jeong ; Seung, Lea Tahk ; Keum, Soo Park ; Kyoo, Rok Han ; Tae, Hoon Ahn ; Moo, Hyun Kim ; Ju, Young Yang ; Chong, Yun Rhim ; Hyeon, Cheol Gwon ; Seong, Wook Park ; Young, Youp Koh ; Seung, Jae Joo ; Soo, Bong Kim ; Dong, Kyu Jin ; Jin, Man Cho ; Kim, Sang Wook ; Jeong, Kyung Kim ; Tae, Ik Kim ; Deug, Young Nah ; Si, Hoon Park ; Sang, Hyun Lee ; Chung, Hang Jae ; Jang, Hyun Cho ; Seung, Won Jin. / Comparison of clinical outcomes following acute myocardial infarctions in hypertensive patients with or without diabetes. In: Korean Circulation Journal. 2009 ; Vol. 39, No. 6. pp. 243-250.
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title = "Comparison of clinical outcomes following acute myocardial infarctions in hypertensive patients with or without diabetes",
abstract = "Background and Objectives: It is thought that patients with diabetes mellitus (DM) have a poor prognosis after an acute myocardial infarction (AMI), but the effect of diabetes on the outcomes of hypertensive patients with AMIs has not been elucidated in the Korean population. The aim of this study was to investigate the effects of diabetes on long-term clinical outcomes following AMIs in patients with hypertension. Subjects and Methods: Using data from the Korea Acute Myocardial Infarction Registry (November 2005 to December 2006), 2,233 hypertensive patients with AMIs were grouped as follows based on the presence of DM: group I, diabetic hypertension (n=892, 544 men, mean age=66.2±10.9 years); and group II, non-diabetic hypertension (n=1341, 938 men, mean age=63.9±12.8 years). The primary study outcomes included in-hospital death and major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), repeat percutaneous coronary intervention, and coronary artery bypass surgery) at the 1 year follow-up. Results: Hypertensive patients with DM were older and more likely to be women. The diabetic group had lower blood pressure (p<0.001), a lower left ventricular ejection fraction (p<0.001), a more severe degree of heart failure (p<0.001), a longer duration of coronary care unit admission (p<0.001), and a higher incidence of hyperlipidemia (p=0.007). The N-terminal pro-brain natriuretic peptide level (4602.5±8710.6 pg/mL vs. 2320.8±5837.9 pg/mL, p<0.001) was higher and the creatinine clearance (62.4±29.9 mL/min vs. 73.0±40.8 mL/min, p<0.001) was lower in the diabetic group than the non-diabetic group. Coronary angiographic findings revealed more frequent involvement of the left main stem (p=0.002) and multiple vessels (p<0.001) in the diabetic group. The rate of in-hospital death was higher in the diabetic group (p<0.001). During follow-up, the rates of composite MACE at 1 month, 6 months, and 12 months were higher in the diabetic group (p<0.001). Conclusion: In hypertensive patients with AMI, DM was associated with worse clinical and angiographic features, with a higher risk of development of severe heart failure, and an increased risk of MACE on long-term clinical follow-up.",
keywords = "Diabetes mellitus, Hypertension, Myocardial infarction",
author = "Min, {Goo Lee} and Myung, {Ho Jeong} and Youngkeun Ahn and Shung, {Chull Chae} and Seung, {Ho Hur} and Taek, {Jong Hong} and Young, {Jo Kim} and In, {Whan Seong} and Jei, {Keon Chae} and Jay, {Young Rhew} and In, {Ho Chae} and Myeong, {Chan Cho} and Jang, {Ho Bae} and Seung-Woon Rha and Chong, {Jim Kim} and Donghoon Choi and Yang, {Soo Jang} and Junghan Yoon and Wook, {Sung Chung} and Jeong, {Gwan Cho} and Ki, {Bae Seung} and Seung, {Jung Park} and Jong, {Hyun Kim} and Jae, {Young Rhew} and Doo, {Il Kim} and Jung, {Han Yoon} and Bon, {Kwon Koo} and Byung, {Ok Kim} and Myoung, {Yong Lee} and Kee, {Sik Kim} and Jin, {Young Hwang} and Seok, {Kyu Oh} and Nae, {Hee Lee} and Kyoung, {Tae Jeong} and Seung, {Lea Tahk} and Keum, {Soo Park} and Kyoo, {Rok Han} and Tae, {Hoon Ahn} and Moo, {Hyun Kim} and Ju, {Young Yang} and Chong, {Yun Rhim} and Hyeon, {Cheol Gwon} and Seong, {Wook Park} and Young, {Youp Koh} and Seung, {Jae Joo} and Soo, {Bong Kim} and Dong, {Kyu Jin} and Jin, {Man Cho} and Kim, {Sang Wook} and Jeong, {Kyung Kim} and Tae, {Ik Kim} and Deug, {Young Nah} and Si, {Hoon Park} and Sang, {Hyun Lee} and Chung, {Hang Jae} and Jang, {Hyun Cho} and Seung, {Won Jin}",
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language = "English",
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TY - JOUR

T1 - Comparison of clinical outcomes following acute myocardial infarctions in hypertensive patients with or without diabetes

AU - Min, Goo Lee

AU - Myung, Ho Jeong

AU - Ahn, Youngkeun

AU - Shung, Chull Chae

AU - Seung, Ho Hur

AU - Taek, Jong Hong

AU - Young, Jo Kim

AU - In, Whan Seong

AU - Jei, Keon Chae

AU - Jay, Young Rhew

AU - In, Ho Chae

AU - Myeong, Chan Cho

AU - Jang, Ho Bae

AU - Rha, Seung-Woon

AU - Chong, Jim Kim

AU - Choi, Donghoon

AU - Yang, Soo Jang

AU - Yoon, Junghan

AU - Wook, Sung Chung

AU - Jeong, Gwan Cho

AU - Ki, Bae Seung

AU - Seung, Jung Park

AU - Jong, Hyun Kim

AU - Jae, Young Rhew

AU - Doo, Il Kim

AU - Jung, Han Yoon

AU - Bon, Kwon Koo

AU - Byung, Ok Kim

AU - Myoung, Yong Lee

AU - Kee, Sik Kim

AU - Jin, Young Hwang

AU - Seok, Kyu Oh

AU - Nae, Hee Lee

AU - Kyoung, Tae Jeong

AU - Seung, Lea Tahk

AU - Keum, Soo Park

AU - Kyoo, Rok Han

AU - Tae, Hoon Ahn

AU - Moo, Hyun Kim

AU - Ju, Young Yang

AU - Chong, Yun Rhim

AU - Hyeon, Cheol Gwon

AU - Seong, Wook Park

AU - Young, Youp Koh

AU - Seung, Jae Joo

AU - Soo, Bong Kim

AU - Dong, Kyu Jin

AU - Jin, Man Cho

AU - Kim, Sang Wook

AU - Jeong, Kyung Kim

AU - Tae, Ik Kim

AU - Deug, Young Nah

AU - Si, Hoon Park

AU - Sang, Hyun Lee

AU - Chung, Hang Jae

AU - Jang, Hyun Cho

AU - Seung, Won Jin

PY - 2009/6/1

Y1 - 2009/6/1

N2 - Background and Objectives: It is thought that patients with diabetes mellitus (DM) have a poor prognosis after an acute myocardial infarction (AMI), but the effect of diabetes on the outcomes of hypertensive patients with AMIs has not been elucidated in the Korean population. The aim of this study was to investigate the effects of diabetes on long-term clinical outcomes following AMIs in patients with hypertension. Subjects and Methods: Using data from the Korea Acute Myocardial Infarction Registry (November 2005 to December 2006), 2,233 hypertensive patients with AMIs were grouped as follows based on the presence of DM: group I, diabetic hypertension (n=892, 544 men, mean age=66.2±10.9 years); and group II, non-diabetic hypertension (n=1341, 938 men, mean age=63.9±12.8 years). The primary study outcomes included in-hospital death and major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), repeat percutaneous coronary intervention, and coronary artery bypass surgery) at the 1 year follow-up. Results: Hypertensive patients with DM were older and more likely to be women. The diabetic group had lower blood pressure (p<0.001), a lower left ventricular ejection fraction (p<0.001), a more severe degree of heart failure (p<0.001), a longer duration of coronary care unit admission (p<0.001), and a higher incidence of hyperlipidemia (p=0.007). The N-terminal pro-brain natriuretic peptide level (4602.5±8710.6 pg/mL vs. 2320.8±5837.9 pg/mL, p<0.001) was higher and the creatinine clearance (62.4±29.9 mL/min vs. 73.0±40.8 mL/min, p<0.001) was lower in the diabetic group than the non-diabetic group. Coronary angiographic findings revealed more frequent involvement of the left main stem (p=0.002) and multiple vessels (p<0.001) in the diabetic group. The rate of in-hospital death was higher in the diabetic group (p<0.001). During follow-up, the rates of composite MACE at 1 month, 6 months, and 12 months were higher in the diabetic group (p<0.001). Conclusion: In hypertensive patients with AMI, DM was associated with worse clinical and angiographic features, with a higher risk of development of severe heart failure, and an increased risk of MACE on long-term clinical follow-up.

AB - Background and Objectives: It is thought that patients with diabetes mellitus (DM) have a poor prognosis after an acute myocardial infarction (AMI), but the effect of diabetes on the outcomes of hypertensive patients with AMIs has not been elucidated in the Korean population. The aim of this study was to investigate the effects of diabetes on long-term clinical outcomes following AMIs in patients with hypertension. Subjects and Methods: Using data from the Korea Acute Myocardial Infarction Registry (November 2005 to December 2006), 2,233 hypertensive patients with AMIs were grouped as follows based on the presence of DM: group I, diabetic hypertension (n=892, 544 men, mean age=66.2±10.9 years); and group II, non-diabetic hypertension (n=1341, 938 men, mean age=63.9±12.8 years). The primary study outcomes included in-hospital death and major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), repeat percutaneous coronary intervention, and coronary artery bypass surgery) at the 1 year follow-up. Results: Hypertensive patients with DM were older and more likely to be women. The diabetic group had lower blood pressure (p<0.001), a lower left ventricular ejection fraction (p<0.001), a more severe degree of heart failure (p<0.001), a longer duration of coronary care unit admission (p<0.001), and a higher incidence of hyperlipidemia (p=0.007). The N-terminal pro-brain natriuretic peptide level (4602.5±8710.6 pg/mL vs. 2320.8±5837.9 pg/mL, p<0.001) was higher and the creatinine clearance (62.4±29.9 mL/min vs. 73.0±40.8 mL/min, p<0.001) was lower in the diabetic group than the non-diabetic group. Coronary angiographic findings revealed more frequent involvement of the left main stem (p=0.002) and multiple vessels (p<0.001) in the diabetic group. The rate of in-hospital death was higher in the diabetic group (p<0.001). During follow-up, the rates of composite MACE at 1 month, 6 months, and 12 months were higher in the diabetic group (p<0.001). Conclusion: In hypertensive patients with AMI, DM was associated with worse clinical and angiographic features, with a higher risk of development of severe heart failure, and an increased risk of MACE on long-term clinical follow-up.

KW - Diabetes mellitus

KW - Hypertension

KW - Myocardial infarction

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U2 - 10.4070/kcj.2009.39.6.243

DO - 10.4070/kcj.2009.39.6.243

M3 - Article

VL - 39

SP - 243

EP - 250

JO - Korean Circulation Journal

JF - Korean Circulation Journal

SN - 1738-5520

IS - 6

ER -