Prognosis After First-Ever Myocardial Infarction in Type 1 Diabetes Is Strongly Affected by Chronic Kidney Disease
Authors' conclusion
Individuals with type 1 diabetes have a high cardiovascular and diabetes-related mortality after their first-ever MI. In particular, poor kidney function is associated with high mortality and excessive risk of secondary cardiovascular events.
Study context
- Population
- Individuals with T1D from the Finnish Diabetic Nephropathy (FinnDiane) Study with no prior myocardial infarction (MI) or coronary revascularization; 253 (6.0%) verified first-ever MIs
- Participants
- 4,217 individuals253 MIs
- Exposure
- Risk factors for mortality after first-ever MI in T1D
- Outcome
- Mortality from cardiovascular or diabetes-related cause
- Follow-up
- Median post-MI 3.07 (IQR 0.02-8.45) years
Methodological detailsprospective cohort (FinnDiane), competing risk analysis (Fine and Gray)
- Prospective cohort (FinnDiane)
- Competing risk analysis (Fine and Gray)
Main finding
As reported in the abstract
Hazard ratio (95% CI)
eGFR category G3independent risk factor
3.27(1.76–6.08)
eGFR category G4independent risk factor
3.62(1.69–7.73)
eGFR category G5independent risk factor
4.03(2.24–7.26)
Prior coronary heart disease diagnosisindependent risk factor
1.50(1.03–2.20)
Older age at MIindependent risk factor
1.03(1.00–1.05)
Acute revascularizationlower mortality
0.35(0.18–0.72)
Subacute revascularizationlower mortality
0.39(0.26–0.59)
- Died during post-MI follow-up (all causes)
- 187 (73.9%)
Observational data: associations, not effects.
Secondary outcomes
Recurrent MI, HF hospitalization and coronary revascularization, by kidney failure
| Estimate | ||
|---|---|---|
| Kidney failureFine and Gray competing risk analyses | subdistribution HR (recurrent MI) 3.27 (95% CI 2.01–5.34) | |
| Kidney failureFine and Gray competing risk analyses | subdistribution HR (HF) 3.76 (95% CI 2.46–5.76) | |
| Kidney failureFine and Gray competing risk analyses | subdistribution HR (coronary revascularization) 3.04 (95% CI 1.89–4.90) | |
| 0.20.5125Ratio (log scale) |
Original publication
Prognosis After First-Ever Myocardial Infarction in Type 1 Diabetes Is Strongly Affected by Chronic Kidney Disease. Diabetes Care. Published 18 November 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →