| Summary: | Survivors after a myocardial infarction (MI), especially those with diabetes mellitus (DM),<br />remain at high risk of further events. Identifying and treating factors that may influence survival<br />may open new therapeutic strategies. We assessed the impact on prognosis of DM and<br />hypovitaminosis D (hypovitD), alone or combined. In this prospective, observational study, 1081<br />patients were enrolled surviving an MI and divided into four groups according to their diabetic and<br />VitD status. The primary end-point was composite of all-cause mortality, angina/MI and heart<br />failure (HF). Secondary outcomes were mortality, HF and angina/MI. During a follow-up of 26.1<br />months (IQR 6.6–64.5), 391 subjects experienced the primary end-point. Patients with DM or<br />hypovitD had similar rate of the composite end-point. Patients with only hypovitD or DM did not<br />differ regarding components of composite end-point (angina p = 0.97, HF p = 0.29, mortality p = 0.62).<br />DM and VitD deficiency had similarly adjusted risks for primary end-point (HR 1.3, 95%CI 1.05–<br />1.61; HR 1.3, 95% CI 1.04–1.64). The adjusted HR for primary composite end-point for patients with<br />hypovitD and DM was 1.69 (95%CI 1.25–2.29, p = 0.001) in comparison to patients with neither<br />hypoD nor DM. In conclusion, DM and hypovitD, individually and synergistically, are associated<br />with a worse outcome after MI.
|
|---|
