지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2009.1
- 수록면
- 243 - 250 (8page)
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초록· 키워드
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Background and Objectives: It is thought that patients with diabetes mellitus (DM) have a poor prognosis after
an acute myocardial infarction (AMI), but the effect of diabetes on the outcomes of hypertensive patients with AMIs has
not been elucidated in the Korean population. The aim of this study was to investigate the effects of diabetes on longterm
clinical outcomes following AMIs in patients with hypertension. Subjects and Methods: Using data from the
Korea Acute Myocardial Infarction Registry (November 2005 to December 2006), 2,233 hypertensive patients with
AMIs were grouped as follows based on the presence of DM: group I, diabetic hypertension (n=892, 544 men, mean
age=66.2±10.9 years); and group II, non-diabetic hypertension (n=1341, 938 men, mean age=63.9±12.8 years).
The primary study outcomes included in-hospital death and major adverse cardiac events (MACE; cardiac death,
myocardial infarction (MI), repeat percutaneous coronary intervention, and coronary artery bypass surgery) at the 1
year follow-up. Results: Hypertensive patients with DM were older and more likely to be women. The diabetic
group had lower blood pressure (p<0.001), a lower left ventricular ejection fraction (p<0.001), a more severe degree
of heart failure (p<0.001), a longer duration of coronary care unit admission (p<0.001), and a higher incidence of
hyperlipidemia (p=0.007). The N-terminal pro-brain natriuretic peptide level (4602.5±8710.6 pg/mL vs. 2320.8
±5837.9 pg/mL, p<0.001) was higher and the creatinine clearance (62.4±29.9 mL/min vs. 73.0±40.8 mL/min,
p<0.001) was lower in the diabetic group than the non-diabetic group. Coronary angiographic findings revealed
more frequent involvement of the left main stem (p=0.002) and multiple vessels (p<0.001) in the diabetic group.
The rate of in-hospital death was higher in the diabetic group (p<0.001). During follow-up, the rates of composite
MACE at 1 month, 6 months, and 12 months were higher in the diabetic group (p<0.001). Conclusion: In hypertensive
patients with AMI, DM was associated with worse clinical and angiographic features, with a higher risk
of development of severe heart failure, and an increased risk of MACE on long-term clinical follow-up.
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