@article{23346, keywords = {Female, Humans, Aged, Double-Blind Method, Male, Treatment Outcome, Middle Aged, Risk Factors, Predictive Value of Tests, Risk Assessment, Time Factors, Kaplan-Meier Estimate, biomarkers, Diabetes Mellitus, Type 2, Multivariate Analysis, Proportional Hazards Models, Hypoglycemic Agents, Acute Coronary Syndrome, Chi-Square Distribution, Blood Glucose, Myocardial Revascularization, Glycated Hemoglobin A, Natriuretic Peptide, Brain, Oxazoles, Peptide Fragments, Thiophenes}, author = {Grobbee Diederick and Toyama Tadashi and Savonitto Stefano and Morici Nuccia and Nozza Anna and Cosentino Francesco and Filardi Pasquale and Murena Ernesto and Morocutti Giorgio and Ferri Marco and Cavallini Claudio and Eijkemans Marinus and Stähli Barbara and Schrieks Ilse and Heerspink H and Malmberg Klas and Schwartz Gregory and A Lincoff Michael and Ryden Lars and Tardif Jean}, title = {Predictors of mortality in hospital survivors with type 2 diabetes mellitus and acute coronary syndromes.}, abstract = {

AIM: To define the predictors of long-term mortality in patients with type 2 diabetes mellitus and recent acute coronary syndrome.

METHODS AND RESULTS: A total of 7226 patients from a randomized trial, testing the effect on cardiovascular outcomes of the dual peroxisome proliferator-activated receptor agonist aleglitazar in patients with type 2 diabetes mellitus and recent acute coronary syndrome (AleCardio trial), were analysed. Median follow-up was 2 years. The independent mortality predictors were defined using Cox regression analysis. The predictive information provided by each variable was calculated as percent of total chi-square of the model. All-cause mortality was 4.0%, with cardiovascular death contributing for 73% of mortality. The mortality prediction model included N-terminal proB-type natriuretic peptide (adjusted hazard ratio = 1.68; 95% confidence interval = 1.51-1.88; 27% of prediction), lack of coronary revascularization (hazard ratio = 2.28; 95% confidence interval = 1.77-2.93; 18% of prediction), age (hazard ratio = 1.04; 95% confidence interval = 1.02-1.05; 15% of prediction), heart rate (hazard ratio = 1.02; 95% confidence interval = 1.01-1.03; 10% of prediction), glycated haemoglobin (hazard ratio = 1.11; 95% confidence interval = 1.03-1.19; 8% of prediction), haemoglobin (hazard ratio = 1.01; 95% confidence interval = 1.00-1.02; 8% of prediction), prior coronary artery bypass (hazard ratio = 1.61; 95% confidence interval = 1.11-2.32; 7% of prediction) and prior myocardial infarction (hazard ratio = 1.40; 95% confidence interval = 1.05-1.87; 6% of prediction).

CONCLUSION: In patients with type 2 diabetes mellitus and recent acute coronary syndrome, mortality prediction is largely dominated by markers of cardiac, rather than metabolic, dysfunction.

}, year = {2018}, journal = {Diab Vasc Dis Res}, volume = {15}, pages = {14-23}, issn = {1752-8984}, doi = {10.1177/1479164117735493}, language = {eng}, }