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Myocardial infarction and prevalence of diabetes mellitus: Is increased casual blood glucose at admission a reliable criterion for the diagnosis of diabetes?
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
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2001 In: European Heart Journal, Vol. 22, 1102-1110 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2001. Vol. 22, 1102-1110 p.
Identifiers
URN: urn:nbn:se:uu:diva-90405OAI: oai:DiVA.org:uu-90405DiVA: diva2:162748
Available from: 2003-05-02 Created: 2003-05-02Bibliographically approved
In thesis
1. Diabetes mellitus and related glucometabolic disturbances in acute myocardial infarction: Diagnosis, prevalence and prognostic implications
Open this publication in new window or tab >>Diabetes mellitus and related glucometabolic disturbances in acute myocardial infarction: Diagnosis, prevalence and prognostic implications
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In patients with diabetes mellitus (DM), acute myocardial infarction (AMI) is a major cause of death. We have studied two populations with respect to the relationship between DM or related glucometabolic disturbances and AMI.

In the first population, the prevalence of DM and the importance of the glycaemic state for the long-term prognosis in non-diabetic patients were investigated in patients with AMI admitted to the Coronary Care Unite at Västerås Central Hospital.

In the second population, the prevalence of impaired glucose tolerance (IGT), DM and other metabolic abnormalities was investigated in patients with AMI and without known DM admitted to the Coronary Care Units at Västerås and Karolinska Hospital, Stockholm.

21% of the patients with AMI had previously known DM and 4% had newly detected DM if diagnosis is based upon fasting blood glucose (F-BG). The glycemic state, measured as HbA1c, at a 5.5 years follow-up was a risk factor for re-infarction and/or death in non-diabetic patients after AMI.

If an oral glucose tolerance test (OGTT) is performed, 40-45% of all patients with AMI have DM and in addition about 30% have IGT. Both an OGTT and a single post-challenge blood glucose value after 60 minutes performed at hospital discharge, were independent predictors of IGT or DM at follow-up. Insulin resistance, measured by homeostatic model assessment (HOMA-IR), decreased during hospital stay, with no further decrease from hospital discharge to follow-up.

In summary, the studies in this dissertation have revealed an unexpectedly high prevalence of abnormal glucose tolerance in patients with AMI. The glycaemic state, reflected by HbA1c, in non-diabetic patients after AMI has an impact on the long-term prognosis. Consequently, in all patients with AMI, HbA1c and casual blood glucose should be measured at admission and, at least, F-BG at hospital discharge.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 64 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1255
Keyword
Medicine, Diabetes mellitus, impaired glucose tolerance, insulin resistance, prevalence, diagnosis, oral glucose tolerance test, acute myocardial infarction, prognosis, Medicin
National Category
Dermatology and Venereal Diseases
Research subject
Medicine
Identifiers
urn:nbn:se:uu:diva-3423 (URN)91-554-5614-6 (ISBN)
Public defence
2003-05-24, Aulan, Gamla Vårdgymnasiet, ingång 21, Västerås, 13:15
Opponent
Supervisors
Available from: 2003-05-02 Created: 2003-05-02Bibliographically approved

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