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Mortality after first myocardial infarction in diabetic and non-diabetic people between 1985 and 2009. The MONICA/KORA registry

  • CARDIOVASCULAR DISEASE
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Abstract

The aim of the study was to analyse mortality after a first myocardial infarction (MI) and its trends in people with diabetes compared to those without diabetes in Southern Germany, 1985–2009. Using data of the population-based MONICA/KORA Myocardial Infarction Registry, we ascertained all patients with a first fatal or non-fatal MI between 1985 and 2009 (n = 16,478, age 25–74 years, 71 % male, 29 % with diabetes). The impact of diabetes and calendar time on mortality was examined using multiple logistic and Cox regression. Survival improved with calendar time: The crude cumulative 5-year survival was 26.9 and 46.3 % among diabetic and non-diabetic individuals (both sexes combined) with a first MI in the years 1985–1989, and 53.6 and 66.6 % among those with a first MI in the years 2005–2009. This significant decrease of mortality was confirmed in multivariate analyses. The proportion of fatal first MIs was significantly higher in diabetic compared to non-diabetic patients [adjusted odds ratio (OR) 1.26; 95 % confidence interval 1.17–1.36]. This association persisted in a similar manner between both sexes with no consistent change of OR over calendar time in which first MIs have been observed. Likewise, multiple adjusted risk of death after a non-fatal first MI was significantly higher among both diabetic men and women [hazard ratio (HR) 1.64; 1.47–1.82, 1.83; 1.55–2.14] with constant HR over calendar time. During the past 25 years, survival has improved in both diabetic and non-diabetic patients with incident MI in a similar manner. However, mortality after a first MI remained significantly higher in the diabetic population, particularly in women.

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Abbreviations

KORA:

Cooperative Health Research in the Region of Augsburg

MI:

Myocardial infarction

MONICA:

Monitoring trends and determinants on cardiovascular diseases

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Acknowledgments

The project was supported by a grant of the German Ministry of Health and the German Diabetes Foundation. The German Diabetes Centre is financed by the German Federal Ministry of Health and by the Northrhine-Westphalian Ministry of Science. The KORA research platform and the MONICA Augsburg studies were initiated and financed by the Helmholtz Zentrum München, German Research Centre for Environmental Health, which is funded by the German Federal Ministry of Education, Science, Research and Technology and by the State of Bavaria. Since the year 2000 the myocardial infarction data collection is co-financed by the German Federal Ministry of Health to provide population-based myocardial infarction morbidity data for the official German Health Report (see www.gbe-bund.de). We thank all members of the Helmholtz Zentrum München, Institute of Epidemiology and the field staff in Augsburg who were involved in the planning and conduction of the study. We wish to thank the local health departments and the private physicians of the study area as well as the clinicians of the hospitals involved for their support. Finally, we express our appreciation to all study participants.

Conflict of interest

All authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institute of Biometrics and Epidemiology, German Diabetes Centre, Leibniz-Centre for Diabetes Research, Heinrich-Heine-University, Düsseldorf, Germany

    Andrea Icks, Heiner Claessen & Guido Giani

  2. Department of Public Health, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany

    Andrea Icks

  3. Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany

    Inge Kirchberger, Margit Heier, Annette Peters, Ines Trentinaglia & Christa Meisinger

  4. MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany

    Inge Kirchberger, Margit Heier & Christa Meisinger

  5. Munich Heart Alliance, Munich, Germany

    Annette Peters

  6. Department of Internal Medicine I - Cardiology, Central Hospital of Augsburg, Augsburg, Germany

    Wolfgang von Scheidt

Authors
  1. Andrea Icks
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  2. Heiner Claessen
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  3. Inge Kirchberger
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  4. Margit Heier
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  5. Annette Peters
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  6. Ines Trentinaglia
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  7. Guido Giani
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  8. Wolfgang von Scheidt
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  9. Christa Meisinger
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Corresponding authors

Correspondence to Andrea Icks or Heiner Claessen.

Additional information

Andrea Icks and Heiner Claessen have contributed equally to this work.

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Icks, A., Claessen, H., Kirchberger, I. et al. Mortality after first myocardial infarction in diabetic and non-diabetic people between 1985 and 2009. The MONICA/KORA registry. Eur J Epidemiol 29, 899–909 (2014). https://doi.org/10.1007/s10654-014-9964-6

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  • DOI: https://doi.org/10.1007/s10654-014-9964-6

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