Abstract
Background: Previous studies have shown that type 2 diabetes (DM2) is associated with sudden cardiac death (SCD) risk in post–myocardial infarction patients. The treatment of coronary artery disease (CAD) as well as DM2 has changed over time. Objective: The purpose of this study was to compare the incidence of SCD in DM2 and nondiabetic patients with CAD and preserved ejection fraction (EF) in a prospective observational study (ARTEMIS study). Methods: In 834 DM2 patients and 1112 nondiabetic patients with CAD enrolled, the EF measured ≥3 months after qualifying was 63% ± 10% in DM2 patients and 65% ± 8% in nondiabetic patients (P <.01). The primary end point was SCD or resuscitation from sudden cardiac arrest (SCA). All-cause mortality, cardiac mortality, non-SCD, hospitalization for heart failure, and acute coronary syndrome were secondary end points. Results: During a mean follow-up of 6.3 ± 1.6 years, SCDs/SCAs occurred in 50 patients. The prevalence of SCD/SCA was higher in DM2 patients (4.1%) than in nondiabetic patients (1.4%) (adjusted hazard ratio 2.6; 95% confidence interval 1.3–5.3; P <.01). However, the non-SCD component of cardiac mortality was not significantly different between DM2 and nondiabetic patients. In addition, heart failure hospitalizations were more common in DM2 patients (8.4%) than in nondiabetic patients (2.9%) (P <.001). The annual cardiac mortality in nondiabetic patients with CAD was 0.50%, which was lower than the 0.59% reported in the general Finnish population. Conclusion: DM2 is an independent risk factor for SCD/SCA in CAD patients with preserved EF. Cardiac mortality in nondiabetic CAD patients is slightly lower than that in the general population in the present treatment era.
Original language | English (US) |
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Pages (from-to) | 1450-1456 |
Number of pages | 7 |
Journal | Heart Rhythm |
Volume | 15 |
Issue number | 10 |
DOIs | |
State | Published - Oct 1 2018 |
Keywords
- Cardiac death
- Coronary artery disease
- Outcome
- Sudden cardiac death
- Type 2 diabetes
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)