uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Prognostic role of the glucometabolic status assessed in a metabolically stable phase after a first acute myocardial infarction: the SHEEP study
Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
Show others and affiliations
2009 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 265, no 4, 465-475 p.Article in journal (Refereed) Published
Abstract [en]


Our objective was to examine fasting glucose and insulin levels in patients surviving 3 months after a first AMI in relation to long-term prognosis.


A total of 1167 consecutive patients between 45 and 70 years with a first nonfatal AMI underwent a standardized clinical examination and were followed for a mean of 8 years for total and cardiac mortality and hospitalization for nonfatal cardiovascular disease. Impaired fasting glucose (IFG) was defined as fasting glucose between 5.6 and 7 mmol L(-1) and a level >or=7 mmol L(-1) as newly detected diabetes. Patients with a fasting glucose level <5.6 mmol L(-1) and without a history of diabetes were classified as normoglycemic (NG). An estimate of insulin resistance was calculated using the homeostasis model assessment (HOMA).


We recorded 219 deaths, 121 deaths from cardiac causes, during the follow-up period. After adjustment for several potential confounders, hazard ratios for total mortality were 1.36 (95% confidence interval 0.93-1.99, P=0.11), 2.27 (1.26-4.09, P=0.006) and 2.15 (1.43-3.21, P<0.001) for patients with IFG, newly detected diabetes and history of diabetes when compared to the NG group. Cardiac mortality, risk of hospitalization for recurrent nonfatal AMI, stroke or heart failure generally showed a similar pattern to that of total mortality. Insulin level and HOMA values were also associated with increased risk for recurrent events.


We confirmed that both known and newly detected diabetes is a strong prognostic factor in AMI. In addition, our findings suggest that glucose levels below the diabetes cut off value might also predict poor long-term prognosis when assessed in a metabolically stable phase.

Place, publisher, year, edition, pages
2009. Vol. 265, no 4, 465-475 p.
Keyword [en]
acute myocardial infarction, diabetes, glucose, HOMA, insulin, prognosis
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-123692DOI: 10.1111/j.1365-2796.2008.02036.xISI: 000264075800006PubMedID: 19019187OAI: oai:DiVA.org:uu-123692DiVA: diva2:315317
Available from: 2010-04-29 Created: 2010-04-29 Last updated: 2012-07-25Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Hallqvist, Johan
In the same journal
Journal of Internal Medicine
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 189 hits
ReferencesLink to record
Permanent link

Direct link