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Effects of insulin treatment on cause specific one-year mortality and morbidity in diabetic patients with acute myocardial infarction
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1996 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 17, no 9, p. 1337-1344Article in journal (Refereed) Published
Abstract [en]

Diabetic patients with acute myocardial infarction have a poor prognosis, which has been attributed to a higher incidence of congestive heart failure and fatal reinfarction. This study reports on the one-year morbidity and mortality in a randomized study with the aim of testing whether insulin-glucose infusion initiated as soon as possible after onset of myocardial infarction and followed by long-term subcutaneous insulin treatment may have a beneficial effect on outcome in diabetic patients. In all, 306 patients were recruited to the insulin-treated group, while 314 patients served as controls. The overall mortality after one year was 19% in the insulin group compared to 26% among controls (P < 0.05). The treatment effect was most pronounced in patients without prior insulin medication and at low cardiovascular risk. In this stratum the in-hospital mortality was reduced by 58% (P < 0.05) and the one-year mortality by 52% (P < 0.02). The most frequent cause of death in all patients was congestive heart failure (66%), but cardiovascular mortality (congestive heart failure, fatal reinfarction, sudden death and stroke) tended to be decreased in insulin-treated patients. However, this difference did not reach the level of statistical significance. The number of reinfarctions was 53 (28% fatal) in the insulin group compared to 55 (45% fatal) in the control group. The two groups did not differ as regards need for hospital care or coronary revascularization during the year of follow-up. In summary, left ventricular failure and fatal reinfarctions contribute to increased mortality in diabetic patients following acute myocardial infarction. Intensive insulin treatment lowered this mortality during one year of follow-up.

Place, publisher, year, edition, pages
Oxford University Press , 1996. Vol. 17, no 9, p. 1337-1344
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hb:diva-7794Local ID: 2320/8703OAI: oai:DiVA.org:hb-7794DiVA, id: diva2:888675
Available from: 2015-12-22 Created: 2015-12-22 Last updated: 2017-10-04Bibliographically approved

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http://eurheartj.oxfordjournals.org/content/17/9/1337.long

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Herlitz, Johan

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CiteExportLink to record
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Citation style
  • apa
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Output format
  • html
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