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

Daisaku Nakatani; Yasuhiko Sakata; Hiroya Mizuno; Masahiko Shimizu; Shinichiro Suna; Masaya Usami; Hiroshi Ito; Yoshio Yasumura; Atsushi Hirayama; Hiroshi Takeda; Masatsugu Hori; Hiroshi Sato; the Osaka Acute Coronary Insufficiency Study (OACIS) Group

doi:10.1253/circj.CJ-08-0579

Heart Failure

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

Daisaku Nakatani, Yasuhiko Sakata, Hiroya Mizuno, Masahiko Shimizu, Shinichiro Suna, Masaya Usami, Hiroshi Ito, Yoshio Yasumura, Atsushi Hirayama, Hiroshi Takeda, Masatsugu Hori, Hiroshi Sato, the Osaka Acute Coronary Insufficiency Study (OACIS) Group

Author information

Daisaku Nakatani
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
Yasuhiko Sakata
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
Hiroya Mizuno
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
Masahiko Shimizu
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
Shinichiro Suna
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
Masaya Usami
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
Hiroshi Ito
Sakurabashi Watanabe Hospital
Yoshio Yasumura
Osaka National Hospital
Atsushi Hirayama
Osaka Police Hospital
Hiroshi Takeda
Department of Medical Information Science, Osaka University Graduate School of Medicine
Masatsugu Hori
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
Hiroshi Sato
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
the Osaka Acute Coronary Insufficiency Study (OACIS) Group

Keywords: Diabetes mellitus, Heart failure, High-sensitivity C-reactive protein, Myocardial infarction

JOURNAL FREE ACCESS

2009 Volume 73 Issue 4 Pages 662-666

DOI https://doi.org/10.1253/circj.CJ-08-0579

View "Advance Publication" version (February 19, 2009).

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Abstract

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 A_1c 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)

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