Record 1 of 2 - MEDLINE EXPRESS (R) 1985-1989

TI: Mortality and morbidity during a five-year follow-up of diabetics with myocardial infarction.

AU: Herlitz-J; Malmberg-K; Karlson-BW; Ryden-L; Hjalmarson-A

AD: Department of Medicine I, Sahlgrenska Hospital, University of Goteborg, Sweden.

SO: Acta-Med-Scand. 1988; 224(1): 31-8

ISSN: 0001-6101

PY: 1988

LA: ENGLISH

CP: SWEDEN

AB: In 787 patients with acute myocardial infarction originally participating in the Goteborg Metoprolol Trial, mortality and morbidity during 5 years' follow-up were assessed and related to whether patients had diabetes mellitus. Diabetes occurred in 78 patients (10%). Patients with diabetes had a different risk factor pattern, including higher age, higher occurrence of angina pectoris and hypertension, whereas smoking habits did not differ. In the early phase (hospitalization), patients with diabetes

had a higher mortality (12% versus 8%), required more treatment for heart failure and stayed longer in hospital. Other morbidity aspects, such as severity of pain, occurrence of severe supraventricular and ventricular arrhythmias, high-degree AV-block and infarct size did not differ. During 5 years' follow-up mortality rate in patients with diabetes mellitus was 55% as compared with 30% among patients with no diabetes (p less than 0.001). Reinfarction rate during 5 years was 42% in diabetics versus 25%

in non-diabetics (p less than 0.001). In a multivariate analysis, taking into account the differences in risk factor pattern, diabetes turned out to be an independent determinant for long-term mortality and reinfarction (p less than 0.001). We conclude that patients with diabetes mellitus, developing acute myocardial infarction, is a group with particularly high risk of death and reinfarction. Interventions aiming at its reduction have priority.

MESH: Aged-; Clinical-Trials; Diabetes-Mellitus-mortality; Double-Blind-Method; Follow-Up-Studies; Middle-Age; Myocardial-Infarction-mortality; Prognosis-; Sweden-

MESH: *Diabetes-Mellitus-complications; *Myocardial-Infarction-complications

TG: Female; Human; Male; Support,-Non-U.S.-Gov't

PT: CLINICAL-TRIAL; JOURNAL-ARTICLE

AN: 1988323829

UD: 198812

Record 2 of 2 - MEDLINE EXPRESS (R) 1993-1995

TI: Role of glucose intolerance in cardiac diastolic function in essential hypertension.

AU: Nagano-N; Nagano-M; Yo-Y; Iiyama-K; Higaki-J; Mikami-H; Ogihara-T

AD: Department of Geriatric Medicine, Osaka University Medical School, Suita, Japan.

SO: Hypertension. 1994 Jun; 23(6 Pt 2): 1002-5

ISSN: 0194-911X

PY: 1994

LA: ENGLISH

CP: UNITED-STATES

AB: Insulin resistance and glucose intolerance have been suggested to be involved in the pathogenesis of various cardiovascular diseases. We examined the role of glucose intolerance in cardiac performance and cardiac hypertrophy in 33 patients with essential hypertension (28 to 71 years of age, mean +/- SD: 53 +/- 13 years) who had never been treated. Patients with obesity (body mass index > 30 kg/m2) or overt diabetes were excluded. Plasma glucose and insulin were measured after oral administration

of 75 g glucose. The incremental areas of glucose and insulin were used as indices of glucose intolerance and insulin resistance, respectively. Patients with impaired glucose tolerance according to World Health Organization criteria (n = 12) showed a significantly higher ratio of peak velocity during atrial contraction to early left ventricular filling phase (A/E ratio) than those with normal glucose tolerance (n = 21) despite similar age, blood pressure, and left ventricular mass index. By regression

analysis, left ventricular mass index positively correlated with systolic blood pressure (r = .392, P < .05) but not with any parameters of glucose and insulin metabolism. A/E ratio determined by a Doppler system significantly correlated with age ( r = .776) and fasting and peak levels and incremental area of plasma glucose (r = .529, r = .468, and r = .634) but not with those parameters of insulin. In contrast, ejection fraction was not related to blood pressure, glucose tolerance, or insulin resistance.(ABSTRACT TRUNCATED AT 250 WORDS)

MESH: Adult-; Aged-; Blood-Flow-Velocity; Blood-Glucose-analysis; Coronary-Circulation; Diastole-; Echocardiography-; Heart-Ventricle; Hypertension-ultrasonography; Middle-Age; Myocardial-Contraction; Regression-Analysis

MESH: *Glucose-Intolerance; *Heart-physiopathology; *Hypertension-physiopathology

TG: Human

PT: JOURNAL-ARTICLE

RN: 0

NM: Blood-Glucose

AN: 1994266401

UD: 199409