Type 2 diabetes increased risk for sudden cardiac death in patients following MI

Junttila MJ. Heart Rhythm. 2010;7:1396-1403.

Issue: December 2010

New data suggest that patients with type 2 diabetes may be at a higher risk for sudden cardiac death after myocardial infarction than patients without diabetes.

“Type 2 diabetes is a well-established risk factor for atherosclerosis, but its contribution to sudden cardiac death (SCD) risk after MI is not well defined,” the researchers wrote. “SCD in the post-MI patient is of special interest because of the magnitude of risk, the challenge of individual risk profiling and the potential for prevention in high-risk individuals.”

The study included 3,276 patients (mean age, 60 years) who were enrolled at the time of acute MI between the years of 1996 and 2005; all patients were followed until 2009. At baseline, 629 patients (19.2%) had type 2 diabetes based upon WHO criteria. Patients with type 1 diabetes and patients with cardiac arrest during or prior to MI were excluded from the study.

Among patients with type 2 diabetes, rate of SCD was notably higher compared with patients without diabetes (5.9% vs. 1.7%; adjusted HR=2.3; 95% CI, 1.4-3.8). The incidence of SCD in patients with diabetes and left ventricular ejection fraction (LVEF) >35% was nearly identical to patients without diabetes and LVEF ≤35% (4.1% vs. 4.9%; P=.48).

Researchers also noted that an excess in the incidence of non-SCD among patients with diabetes started to appear within the first 6 months of follow-up (P<.001). This was not the case for both the incidence and excess of SCD for patients with diabetes, which did not begin to appear until more than 6 months after the index event.

“Further prospective information on post-MI diabetic patients is needed to evaluate indications for, and efficacy of, ICDs and other therapies for this higher-risk subgroup,” the researchers concluded.

Follow EndocrineToday.com on Twitter.