Impact of Diabetes Mellitus on Rehospitalization for Heart Failure Among Survivors of Acute Myocardial Infarction in the Percutaneous Coronary Intervention Era

概要

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Background: There is little data regarding the clinical impact of diabetes mellitus (DM) on heart failure (HF) among survivors of acute myocardial infarction (AMI) in the percutaneous coronary intervention (PCI) era. Methods and Results: The present study group comprised 4,035 survivors who underwent PCI within 24 h of the onset of symptoms. DM was an independent predictor of rehospitalization for HF by multivariate analysis (hazard ratio (HR) 1.576, P=0.010). The risk of rehospitalization for HF was similar between patients with DM who did not have an enlarged left ventricular diastolic diameter (LVDd <51 mm) before discharge and patients without DM who showed an increase in LVDd (≥51 mm) (HR 1.020, P=0.959). In the DM group, the hemoglobin A1c level before discharge was similar between patients with and without rehospitalization for HF (7.5 ±1.9% vs 7.4 ±1.6%, P=0.455), whereas high-sensitivity C-reactive protein (hs-CRP) was higher in patients with than without rehospitalization for HF (1.80 ±3.63 vs 0.75 ±2.03 mg/dl, P=0.001). Conclusions: DM is an independent predictor of rehospitalization for HF after AMI in the PCI era. Diabetic patients without left ventricular remodeling should be treated as a high-risk group for HF. Measurement of hs-CRP level may be useful for predicting rehospitalization because of HF in diabetic patients after AMI. (Circ J 2009; 73: 662 - 666)
社団法人　日本循環器学会の論文
2009-03-20