Newly diagnosed and previously known diabetes mellitus and 1-year outcomes of acute myocardial infarction: The Valsartan in acute myocardial infarction (VALIANT) trial

David Aguilar, Scott D. Solomon, Lars Koøber, Jean Lucien Rouleau, Hicham Skali, John J V McMurray, Gary S. Francis, Marc Henis, Christopher M. O'Connor, Rafael Diaz, Yuri N. Belenkov, Sergei Varshavsky, Jeffrey D. Leimberger, Eric J. Velazquez, Robert M. Califf, Marc A. Pfeffer

Research output: Contribution to journalArticlepeer-review

181 Scopus citations

Abstract

Background - A prior diagnosis of diabetes mellitus is associated with adverse outcomes after acute myocardial infarction (MI), but the risk associated with a new diagnosis of diabetes in this setting has not been well defined. Methods and Results - We assessed the risk of death and major cardiovascular events associated with previously known and newly diagnosed diabetes by studying 14 703 patients with acute MI enrolled in the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. Patients were grouped by diabetic status: previously known diabetes (insulin use or diagnosis of diabetes before MI, n=3400, 23%); newly diagnosed diabetes (use of diabetic therapy or diabetes diagnosed at randomization [median 4.9 d after infarction], but no known diabetes at presentation, n=580, 4%); or no diabetes (n=10 719). Patients with newly diagnosed diabetes were younger and had fewer comorbid conditions than did patients with previously known diabetes. At 1 year after enrollment, patients with previously known and newly diagnosed diabetes had similarly increased adjusted risks of mortality (hazard ratio [HR] 1.43; 95% confidence interval [CI], 1.29 to 1.59 and HR, 1.50; 95% CI, 1.21 to 1.85, respectively) and cardiovascular events (HR, 1.37; 95% CI, 1.27 to 1.48 and HR, 1.34; 95% CI, 1.14 to 1.56). Conclusions - Diabetes mellitus, whether newly diagnosed or previously known, is associated with poorer long-term outcomes after MI in high-risk patients. The poor prognosis of patients with newly diagnosed diabetes, despite having baseline characteristics similar to those of patients without diabetes, supports the idea that metabolic abnormalities contribute to their adverse outcomes.

Original languageEnglish (US)
Pages (from-to)1572-1578
Number of pages7
JournalCirculation
Volume110
Issue number12
DOIs
StatePublished - Sep 21 2004

Keywords

  • Diabetes mellitus
  • Heart failure
  • Myocardial infarction
  • Prognosis

Fingerprint Dive into the research topics of 'Newly diagnosed and previously known diabetes mellitus and 1-year outcomes of acute myocardial infarction: The Valsartan in acute myocardial infarction (VALIANT) trial'. Together they form a unique fingerprint.

Cite this