Prediabetes and risk for cardiac death among patients with coronary artery disease: The ARTEMIS study

Antti M. Kiviniemi, E. Samuli Lepojärvi, Mikko P. Tulppo, Olli Pekka Piira, Tuomas V. Kenttä, Juha S. Perkiömäki, Olavi H. Ukkola, Robert J Myerburg, M. Juhani Junttila, Heikki V. Huikuri

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE To compare cardiac mortality in patients with CAD and prediabetes with that in CAD patients with normal glycemic status and type 2 diabetes. RESEARCH DESIGN AND METHODS The Innovation to Reduce Cardiovascular Complications of Diabetes at the Intersection (ARTEMIS) study included patients with CAD after revascularization (79%), optimal medical therapy, or both. Patients had type 2 diabetes (n = 834), impaired glucose tolerance (IGT; n = 314), impaired fasting glucose (IFG; n = 103), or normal glycemic status (n = 697) as defined on the basis of the results of an oral glucose tolerance test. The primary end point was cardiac death. Major adverse cardiac event (MACE: Cardiac death, heart failure, or acute coronary syndrome) and all-cause mortality were secondary end points. RESULTS During a mean 6 SD follow-up of 6.3 6 1.6 years, 101 cardiac deaths, 385 MACEs, and 208 deaths occurred. Patients with IGT tended to have 49% lower adjusted risk for cardiac death (P = 0.069), 32% lower adjusted risk for all-cause mortality (P = 0.076), and 36% lower adjusted risk for MACE (P = 0.011) than patients with type 2 diabetes. The patients with IFG had 82% lower adjusted risk for all-cause mortality (P = 0.015) than the patients with type 2 diabetes, whereas risks for cardiac death and MACE did not differ significantly between the two groups. The adjusted risks for cardiac death, MACE, and all-cause mortality among patients with IGT and IFG did not significantly differ from those risks among patients with normal glycemic status. CONCLUSIONS Cardiac mortality or incidence of MACE in patients with CAD with prediabetes (i.e., IGT or IFG after revascularization, optimal medical therapy, or both) does not differ from those values in patients with normal glycemic status.

Original languageEnglish (US)
Pages (from-to)1319-1325
Number of pages7
JournalDiabetes care
Volume42
Issue number7
DOIs
StatePublished - Jan 1 2019

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Prediabetic State
Coronary Artery Disease
Type 2 Diabetes Mellitus
Mortality
Glucose Intolerance
Diabetes Complications
Acute Coronary Syndrome
Glucose Tolerance Test
Fasting

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Kiviniemi, A. M., Lepojärvi, E. S., Tulppo, M. P., Piira, O. P., Kenttä, T. V., Perkiömäki, J. S., ... Huikuri, H. V. (2019). Prediabetes and risk for cardiac death among patients with coronary artery disease: The ARTEMIS study. Diabetes care, 42(7), 1319-1325. https://doi.org/10.2337/dc18-2549

Prediabetes and risk for cardiac death among patients with coronary artery disease : The ARTEMIS study. / Kiviniemi, Antti M.; Lepojärvi, E. Samuli; Tulppo, Mikko P.; Piira, Olli Pekka; Kenttä, Tuomas V.; Perkiömäki, Juha S.; Ukkola, Olavi H.; Myerburg, Robert J; Junttila, M. Juhani; Huikuri, Heikki V.

In: Diabetes care, Vol. 42, No. 7, 01.01.2019, p. 1319-1325.

Research output: Contribution to journalArticle

Kiviniemi, AM, Lepojärvi, ES, Tulppo, MP, Piira, OP, Kenttä, TV, Perkiömäki, JS, Ukkola, OH, Myerburg, RJ, Junttila, MJ & Huikuri, HV 2019, 'Prediabetes and risk for cardiac death among patients with coronary artery disease: The ARTEMIS study', Diabetes care, vol. 42, no. 7, pp. 1319-1325. https://doi.org/10.2337/dc18-2549
Kiviniemi AM, Lepojärvi ES, Tulppo MP, Piira OP, Kenttä TV, Perkiömäki JS et al. Prediabetes and risk for cardiac death among patients with coronary artery disease: The ARTEMIS study. Diabetes care. 2019 Jan 1;42(7):1319-1325. https://doi.org/10.2337/dc18-2549
Kiviniemi, Antti M. ; Lepojärvi, E. Samuli ; Tulppo, Mikko P. ; Piira, Olli Pekka ; Kenttä, Tuomas V. ; Perkiömäki, Juha S. ; Ukkola, Olavi H. ; Myerburg, Robert J ; Junttila, M. Juhani ; Huikuri, Heikki V. / Prediabetes and risk for cardiac death among patients with coronary artery disease : The ARTEMIS study. In: Diabetes care. 2019 ; Vol. 42, No. 7. pp. 1319-1325.
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abstract = "OBJECTIVE To compare cardiac mortality in patients with CAD and prediabetes with that in CAD patients with normal glycemic status and type 2 diabetes. RESEARCH DESIGN AND METHODS The Innovation to Reduce Cardiovascular Complications of Diabetes at the Intersection (ARTEMIS) study included patients with CAD after revascularization (79{\%}), optimal medical therapy, or both. Patients had type 2 diabetes (n = 834), impaired glucose tolerance (IGT; n = 314), impaired fasting glucose (IFG; n = 103), or normal glycemic status (n = 697) as defined on the basis of the results of an oral glucose tolerance test. The primary end point was cardiac death. Major adverse cardiac event (MACE: Cardiac death, heart failure, or acute coronary syndrome) and all-cause mortality were secondary end points. RESULTS During a mean 6 SD follow-up of 6.3 6 1.6 years, 101 cardiac deaths, 385 MACEs, and 208 deaths occurred. Patients with IGT tended to have 49{\%} lower adjusted risk for cardiac death (P = 0.069), 32{\%} lower adjusted risk for all-cause mortality (P = 0.076), and 36{\%} lower adjusted risk for MACE (P = 0.011) than patients with type 2 diabetes. The patients with IFG had 82{\%} lower adjusted risk for all-cause mortality (P = 0.015) than the patients with type 2 diabetes, whereas risks for cardiac death and MACE did not differ significantly between the two groups. The adjusted risks for cardiac death, MACE, and all-cause mortality among patients with IGT and IFG did not significantly differ from those risks among patients with normal glycemic status. CONCLUSIONS Cardiac mortality or incidence of MACE in patients with CAD with prediabetes (i.e., IGT or IFG after revascularization, optimal medical therapy, or both) does not differ from those values in patients with normal glycemic status.",
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T1 - Prediabetes and risk for cardiac death among patients with coronary artery disease

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AU - Kiviniemi, Antti M.

AU - Lepojärvi, E. Samuli

AU - Tulppo, Mikko P.

AU - Piira, Olli Pekka

AU - Kenttä, Tuomas V.

AU - Perkiömäki, Juha S.

AU - Ukkola, Olavi H.

AU - Myerburg, Robert J

AU - Junttila, M. Juhani

AU - Huikuri, Heikki V.

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N2 - OBJECTIVE To compare cardiac mortality in patients with CAD and prediabetes with that in CAD patients with normal glycemic status and type 2 diabetes. RESEARCH DESIGN AND METHODS The Innovation to Reduce Cardiovascular Complications of Diabetes at the Intersection (ARTEMIS) study included patients with CAD after revascularization (79%), optimal medical therapy, or both. Patients had type 2 diabetes (n = 834), impaired glucose tolerance (IGT; n = 314), impaired fasting glucose (IFG; n = 103), or normal glycemic status (n = 697) as defined on the basis of the results of an oral glucose tolerance test. The primary end point was cardiac death. Major adverse cardiac event (MACE: Cardiac death, heart failure, or acute coronary syndrome) and all-cause mortality were secondary end points. RESULTS During a mean 6 SD follow-up of 6.3 6 1.6 years, 101 cardiac deaths, 385 MACEs, and 208 deaths occurred. Patients with IGT tended to have 49% lower adjusted risk for cardiac death (P = 0.069), 32% lower adjusted risk for all-cause mortality (P = 0.076), and 36% lower adjusted risk for MACE (P = 0.011) than patients with type 2 diabetes. The patients with IFG had 82% lower adjusted risk for all-cause mortality (P = 0.015) than the patients with type 2 diabetes, whereas risks for cardiac death and MACE did not differ significantly between the two groups. The adjusted risks for cardiac death, MACE, and all-cause mortality among patients with IGT and IFG did not significantly differ from those risks among patients with normal glycemic status. CONCLUSIONS Cardiac mortality or incidence of MACE in patients with CAD with prediabetes (i.e., IGT or IFG after revascularization, optimal medical therapy, or both) does not differ from those values in patients with normal glycemic status.

AB - OBJECTIVE To compare cardiac mortality in patients with CAD and prediabetes with that in CAD patients with normal glycemic status and type 2 diabetes. RESEARCH DESIGN AND METHODS The Innovation to Reduce Cardiovascular Complications of Diabetes at the Intersection (ARTEMIS) study included patients with CAD after revascularization (79%), optimal medical therapy, or both. Patients had type 2 diabetes (n = 834), impaired glucose tolerance (IGT; n = 314), impaired fasting glucose (IFG; n = 103), or normal glycemic status (n = 697) as defined on the basis of the results of an oral glucose tolerance test. The primary end point was cardiac death. Major adverse cardiac event (MACE: Cardiac death, heart failure, or acute coronary syndrome) and all-cause mortality were secondary end points. RESULTS During a mean 6 SD follow-up of 6.3 6 1.6 years, 101 cardiac deaths, 385 MACEs, and 208 deaths occurred. Patients with IGT tended to have 49% lower adjusted risk for cardiac death (P = 0.069), 32% lower adjusted risk for all-cause mortality (P = 0.076), and 36% lower adjusted risk for MACE (P = 0.011) than patients with type 2 diabetes. The patients with IFG had 82% lower adjusted risk for all-cause mortality (P = 0.015) than the patients with type 2 diabetes, whereas risks for cardiac death and MACE did not differ significantly between the two groups. The adjusted risks for cardiac death, MACE, and all-cause mortality among patients with IGT and IFG did not significantly differ from those risks among patients with normal glycemic status. CONCLUSIONS Cardiac mortality or incidence of MACE in patients with CAD with prediabetes (i.e., IGT or IFG after revascularization, optimal medical therapy, or both) does not differ from those values in patients with normal glycemic status.

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