Acute Myocardial Infarction Is a Risk Factor for New Onset Diabetes in Patients with Coronary Artery Disease

• DOI: 10.1371/journal.pone.0136354
• Publication Date: 2015-08-21T17:59:27Z
• Authors: Chul Soo Park; Woo Baek Chung; Yun Seok Choi; Pum Joon Kim; Jong Min Lee; Ki-Hyun Baek; Hee Yeol Kim; Ki Dong Yoo; Ki-Ho Song; Wook Sung Chung; Ki Bae Seung; Man Young Lee; Hyuk-Sang Kwon
• Keywords: Male; Science; Q; R; Myocardial Infarction; Coronary Artery Disease; Middle Aged; Prognosis; 3. Good health; 03 medical and health sciences; Logistic Models; Percutaneous Coronary Intervention; 0302 clinical medicine; Risk Factors; Diabetes Mellitus; Medicine; Humans; Female; Registries; Research Article; Aged; Proportional Hazards Models; Retrospective Studies

To test the hypothesis that acute myocardial infarction (AMI) might accelerate development of new onset diabetes in patients with coronary artery disease independent of known risk factors.We conducted a retrospective cohort study within COACT (CathOlic medical center percutAneous Coronary inTervention) registry. From a total of 9,127 subjects, 2,036 subjects were diabetes naïve and followed up for at least one year with both index and follow-up laboratory data about diabetes. Cox proportional hazard model was used to derive hazard ratios (HRs) and 95% confidence interval (CI) for new onset diabetes associated with AMI in univariate and multivariate analysis after adjusting several covariates.The overall hazard for diabetes was higher in AMI compared to non-AMI patients (p by log rank <0.01) with HR of 1.78 and 95% CI of 1.37-2.32 in univariate analysis. This association remained significant after adjusting covariates (HR, 1.54; 95% CI, 1.14-2.07; p<0.01). AMI was an independent predictor for higher quartile of WBC count in multivariate ordinal logistic regression analysis (OR, 6.75; 95% CI, 5.53-8.22, p<0.01). In subgroup analysis, the diabetogenic effect of AMI was more prominent in the subgroup without MetS compared to MetS patients (p for interaction<0.05). Compared to the reference group of non-AMI+nonMetS, the group of AMI+non-MetS (HR, 2.44; 95% CI, 1.58-3.76), non-AMI+MetS (HR, 3.42; 95% CI, 2.34-4.98) and AMI+MetS (HR, 4.12; 95% CI, 2.67-6.36) showed higher HR after adjusting covariates. However, the hazard was not different between the non-AMI+MetS and AMI+non-MetS groups.AMI patients have a greater risk of new-onset diabetes when compared to non AMI patients, especially those with mild metabolic abnormalities.