Long-term all-cause and cardiovascular mortality following incident myocardial infarction in men and women with and without diabetes: Temporal trends from 1998 to 2009

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Abstract

© European Society of Cardiology 2015.
Background Long-term mortality following myocardial infarction is higher in diabetic than non-diabetic individuals. Early case-fatality after myocardial infarction has improved but it is unclear whether trends extend to long-term mortality. We aimed to determine whether the disparity in long-term all-cause and cardiovascular disease mortality by diabetes status has decreased. Methods All incident myocardial infarction cases were identified from Western Australian whole-population linked data for 1998-2009. Mortality follow-up was available until 30 June 2011. Unadjusted survival was estimated using Kaplan-Meier survival curves. Hazard ratios comparing five-year mortality in diabetic versus non-diabetic people across three periods (1998-2001, 2002-2005, 2006-2009) were estimated from multivariable Cox regression models, and adjusted trends calculated from interaction (diabetes status × period) models. Results There were 22,594 30-day survivors of incident MI. There was little change across the three periods in all-cause mortality in diabetic men (27.1%, 28.2%, 25.5%) and women (34.9%, 36.8%, 36.1%), but small declines from first to last periods in non-diabetic men (14.5% to 12.1%, p = 0.03) and women (21.0% to 19.4%, p = 0.08). There was no temporal change in the increased all-cause mortality hazard ratios in diabetic versus non-diabetic men and women. Multivariable-adjusted relative risk for cardiovascular disease mortality remained elevated in diabetic women (2006-2009 hazard ratio 1.73, 95% confidence interval 1.29, 2.32) but not in men (2006-2009 hazard ratio 1.08, 95% confidence interval 0.85, 1.37). Conclusions The excess long-term mortality associated with diabetes and excess cardiovascular disease mortality in diabetic women indicates a need for improved secondary prevention in diabetic patients, especially women.
Original languageEnglish
Pages (from-to)1273-1281
Number of pages12
JournalEuropean Journal of Preventive Cardiology
Volume23
Issue number12
Early online date23 Feb 2016
DOIs
Publication statusPublished - Aug 2016

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Myocardial Infarction
Mortality
Cardiovascular Diseases
Confidence Intervals
Kaplan-Meier Estimate
Secondary Prevention
Proportional Hazards Models
Survivors
Survival
Population

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@article{c5538f3949a44eeb987895c244ccba23,
title = "Long-term all-cause and cardiovascular mortality following incident myocardial infarction in men and women with and without diabetes: Temporal trends from 1998 to 2009",
abstract = "{\circledC} European Society of Cardiology 2015.Background Long-term mortality following myocardial infarction is higher in diabetic than non-diabetic individuals. Early case-fatality after myocardial infarction has improved but it is unclear whether trends extend to long-term mortality. We aimed to determine whether the disparity in long-term all-cause and cardiovascular disease mortality by diabetes status has decreased. Methods All incident myocardial infarction cases were identified from Western Australian whole-population linked data for 1998-2009. Mortality follow-up was available until 30 June 2011. Unadjusted survival was estimated using Kaplan-Meier survival curves. Hazard ratios comparing five-year mortality in diabetic versus non-diabetic people across three periods (1998-2001, 2002-2005, 2006-2009) were estimated from multivariable Cox regression models, and adjusted trends calculated from interaction (diabetes status × period) models. Results There were 22,594 30-day survivors of incident MI. There was little change across the three periods in all-cause mortality in diabetic men (27.1{\%}, 28.2{\%}, 25.5{\%}) and women (34.9{\%}, 36.8{\%}, 36.1{\%}), but small declines from first to last periods in non-diabetic men (14.5{\%} to 12.1{\%}, p = 0.03) and women (21.0{\%} to 19.4{\%}, p = 0.08). There was no temporal change in the increased all-cause mortality hazard ratios in diabetic versus non-diabetic men and women. Multivariable-adjusted relative risk for cardiovascular disease mortality remained elevated in diabetic women (2006-2009 hazard ratio 1.73, 95{\%} confidence interval 1.29, 2.32) but not in men (2006-2009 hazard ratio 1.08, 95{\%} confidence interval 0.85, 1.37). Conclusions The excess long-term mortality associated with diabetes and excess cardiovascular disease mortality in diabetic women indicates a need for improved secondary prevention in diabetic patients, especially women.",
author = "Lee Nedkoff and Matthew Knuiman and Joe Hung and Briffa, {Tom G.}",
year = "2016",
month = "8",
doi = "10.1177/2047487316634279",
language = "English",
volume = "23",
pages = "1273--1281",
journal = "European Journal of Cardiovascular Prevention & Rehabilitation",
issn = "1350-6277",
publisher = "SAGE Publications Ltd",
number = "12",

}

TY - JOUR

T1 - Long-term all-cause and cardiovascular mortality following incident myocardial infarction in men and women with and without diabetes: Temporal trends from 1998 to 2009

AU - Nedkoff, Lee

AU - Knuiman, Matthew

AU - Hung, Joe

AU - Briffa, Tom G.

PY - 2016/8

Y1 - 2016/8

N2 - © European Society of Cardiology 2015.Background Long-term mortality following myocardial infarction is higher in diabetic than non-diabetic individuals. Early case-fatality after myocardial infarction has improved but it is unclear whether trends extend to long-term mortality. We aimed to determine whether the disparity in long-term all-cause and cardiovascular disease mortality by diabetes status has decreased. Methods All incident myocardial infarction cases were identified from Western Australian whole-population linked data for 1998-2009. Mortality follow-up was available until 30 June 2011. Unadjusted survival was estimated using Kaplan-Meier survival curves. Hazard ratios comparing five-year mortality in diabetic versus non-diabetic people across three periods (1998-2001, 2002-2005, 2006-2009) were estimated from multivariable Cox regression models, and adjusted trends calculated from interaction (diabetes status × period) models. Results There were 22,594 30-day survivors of incident MI. There was little change across the three periods in all-cause mortality in diabetic men (27.1%, 28.2%, 25.5%) and women (34.9%, 36.8%, 36.1%), but small declines from first to last periods in non-diabetic men (14.5% to 12.1%, p = 0.03) and women (21.0% to 19.4%, p = 0.08). There was no temporal change in the increased all-cause mortality hazard ratios in diabetic versus non-diabetic men and women. Multivariable-adjusted relative risk for cardiovascular disease mortality remained elevated in diabetic women (2006-2009 hazard ratio 1.73, 95% confidence interval 1.29, 2.32) but not in men (2006-2009 hazard ratio 1.08, 95% confidence interval 0.85, 1.37). Conclusions The excess long-term mortality associated with diabetes and excess cardiovascular disease mortality in diabetic women indicates a need for improved secondary prevention in diabetic patients, especially women.

AB - © European Society of Cardiology 2015.Background Long-term mortality following myocardial infarction is higher in diabetic than non-diabetic individuals. Early case-fatality after myocardial infarction has improved but it is unclear whether trends extend to long-term mortality. We aimed to determine whether the disparity in long-term all-cause and cardiovascular disease mortality by diabetes status has decreased. Methods All incident myocardial infarction cases were identified from Western Australian whole-population linked data for 1998-2009. Mortality follow-up was available until 30 June 2011. Unadjusted survival was estimated using Kaplan-Meier survival curves. Hazard ratios comparing five-year mortality in diabetic versus non-diabetic people across three periods (1998-2001, 2002-2005, 2006-2009) were estimated from multivariable Cox regression models, and adjusted trends calculated from interaction (diabetes status × period) models. Results There were 22,594 30-day survivors of incident MI. There was little change across the three periods in all-cause mortality in diabetic men (27.1%, 28.2%, 25.5%) and women (34.9%, 36.8%, 36.1%), but small declines from first to last periods in non-diabetic men (14.5% to 12.1%, p = 0.03) and women (21.0% to 19.4%, p = 0.08). There was no temporal change in the increased all-cause mortality hazard ratios in diabetic versus non-diabetic men and women. Multivariable-adjusted relative risk for cardiovascular disease mortality remained elevated in diabetic women (2006-2009 hazard ratio 1.73, 95% confidence interval 1.29, 2.32) but not in men (2006-2009 hazard ratio 1.08, 95% confidence interval 0.85, 1.37). Conclusions The excess long-term mortality associated with diabetes and excess cardiovascular disease mortality in diabetic women indicates a need for improved secondary prevention in diabetic patients, especially women.

U2 - 10.1177/2047487316634279

DO - 10.1177/2047487316634279

M3 - Article

VL - 23

SP - 1273

EP - 1281

JO - European Journal of Cardiovascular Prevention & Rehabilitation

JF - European Journal of Cardiovascular Prevention & Rehabilitation

SN - 1350-6277

IS - 12

ER -