Clinical characteristics and prognostic implications of diabetes and myocardial injury in patients admitted to the emergency room.

Abstract

BACKGROUND:

This study aimed to investigate the clinical features and prognosis of diabetes and myocardial injury in patients admitted to the emergency department.

METHODS:

We analyzed the clinical data of all consecutive patients admitted to the emergency department during the years 2012 and 2013 with at least 1 cardiac Troponin I (cTnI Ultra Siemens, Advia Centaur) determination, and were classified according to the status of diabetes mellitus (DM) and myocardial injury (MI). Clinical events were evaluated in a 4-year follow-up.

RESULTS:

A total of 3622 patients were classified according to the presence of DM (n = 924 (25.55%)) and MI (n = 1049 (28.96%)). The proportion of MI in patients with DM was 40% and 25% in patients without DM. Mortality during follow-up was 10.9% in non-DM patients without MI, 21.3% in DM patients without MI, 40.1% in non-DM patients with MI, and 52.8% in DM patients with MI. A competitive risk model was used to obtain the Hazard Ratio (HR) for readmission for myocardial infarction or heart failure. There was a similar proportion of readmission for myocardial infarction and heart failure at a four-year follow-up in patients with DM or MI, which was much higher when DM was associated with MI, with respect to patients without DM or MI. The HR (95% Coefficient Interval) for myocardial infarction in the DM without MI, non-DM with MI, and DM with MI groups with respect to the non-DM without MI group was 2511 (1592-3960), 2682 (1739-4138), and 5036 (3221-7876), respectively. The HR (95% CI) for the risk of readmission for heart failure in the DM without MI, non-DM with MI, and DM with MI groups with respect to the non-DM without MI group was 2663 (1825-3886), 2562 (1753-3744) and 4292 (2936-6274), respectively.

CONCLUSIONS:

The association of DM and MI in patients treated in an Emergency Service identifies patients at very high risk of mortality and cardiovascular events.

• Authors: Gil Bonet, Anna Carrasquer, Óscar M Peiró, Raul Sanchez-Gimenez, Nisha Lal-Trehan, Victor Del-Moral-Ronda, Isabel Fort-Gallifa, Alfredo Bardají
• Journal: BMC cardiovascular disorders (BMC Cardiovasc Disord) Vol. 21 Issue 1 Pg. 414 (08 30 2021) ISSN: 1471-2261 [Electronic] England
• PMID: 34461832 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s).

Chemical References

• Biomarkers
• Troponin I

Topics

• Aged
• Aged, 80 and over
• Biomarkers (blood)
• Diabetes Mellitus (diagnosis, epidemiology, mortality, therapy)
• Disease Progression
• Emergency Service, Hospital
• Female
• Heart Failure (diagnosis, epidemiology, mortality, therapy)
• Humans
• Male
• Middle Aged
• Myocardial Infarction (diagnosis, epidemiology, mortality, therapy)
• Patient Admission
• Patient Readmission
• Prognosis
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Spain (epidemiology)
• Time Factors
• Troponin I (blood)