Effect of hypoglycemic therapy on cardiovascular events in diabetic patients after acute myocardial infarction
WAN Wen-ting ZHOU Jing CUI Hai-ming QIAN Jia FAN Min▲
Department of Cardiovascular Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
Abstract：Objective To explore the comprehensive risk of acute myocardial infarction recurrence, congestive heart failure and death in patients with acute myocardial infarction using different options to treat diabetes. Methods A retrospective cohort study was conducted on patients with acute myocardial infarction who were hospitalized in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine from April 1, 2015 to March 31, 2018. Among the 1432 with acute myocardial infarction, 1006 patients were without diabetes, 98 diabetic patients were without medication, 241 diabetic patients were treated with oral hypoglycemic drugs,and 87 diabetic patients were treated with insulin. A Cox proportional hazard model was established to calculate the comprehensive risk of different diabetes treatment options for the prognosis of patients with acute myocardial infarction.Results The differences in gender, hypertension, heart failure, and kidney disease between diabetic and non-diabetic patients were statistically significant (P＜0.05). After adjusting age and related factors by Cox regression, the results showed that compared with non-diabetic patients, there was a significant increase in risk among diabetic patients without medication (HR=1.37, 95%CI:1.22-1.53), diabetic patients treated with oral hypoglycemic drugs (HR=1.43,95%CI:1.31-1.56) and insulin-treated patients (HR=1.65, 95%CI:1.48-1.84). Conclusion The incidence of cardiovascular events in insulin-treated diabetic patients is higher than that in diabetic patients treated with oral hypoglycemic drugs and non-diabetic patients.
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