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) |
|---|---|
| Pages (from-to) | 1450-1456 |
| Number of pages | 7 |
| Journal | Heart Rhythm |
| Volume | 15 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2018 |
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Keywords
- Cardiac death
- Coronary artery disease
- Outcome
- Sudden cardiac death
- Type 2 diabetes
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
Cite this
Type 2 diabetes and coronary artery disease : Preserved ejection fraction and sudden cardiac death. / Junttila, M. Juhani; Kiviniemi, Antti M.; Lepojärvi, E. Samuli; Tulppo, Mikko; Piira, Olli Pekka; Kenttä, Tuomas; Perkiömäki, Juha S.; Ukkola, Olavi H.; Myerburg, Robert J; Huikuri, Heikki V.
In: Heart Rhythm, Vol. 15, No. 10, 01.10.2018, p. 1450-1456.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Type 2 diabetes and coronary artery disease
T2 - Preserved ejection fraction and sudden cardiac death
AU - Junttila, M. Juhani
AU - Kiviniemi, Antti M.
AU - Lepojärvi, E. Samuli
AU - Tulppo, Mikko
AU - Piira, Olli Pekka
AU - Kenttä, Tuomas
AU - Perkiömäki, Juha S.
AU - Ukkola, Olavi H.
AU - Myerburg, Robert J
AU - Huikuri, Heikki V.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - 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.
AB - 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.
KW - Cardiac death
KW - Coronary artery disease
KW - Outcome
KW - Sudden cardiac death
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85053501353&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053501353&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2018.06.017
DO - 10.1016/j.hrthm.2018.06.017
M3 - Article
C2 - 30274618
AN - SCOPUS:85053501353
VL - 15
SP - 1450
EP - 1456
JO - Heart Rhythm
JF - Heart Rhythm
SN - 1547-5271
IS - 10
ER -