Higher incidence rate of impaired fasting glucose and diabetes in patients with myocardial infarction
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Data of 8291 Italian patients with a myocardial infarction within the previous 3 months who were free of diabetes at baseline (i.e. at the time of myocardial infarction) were used prospectively to estimate the incidence of new-onset diabetes (new diabetes medication or fasting glucose ≥7 mmol/L) and impaired fasting glucose (fasting glucose ≥6.1 mmol/L and <7 mmol/L). A Mediterranean diet score was assigned according to consumption of cooked and raw vegetables, fruit, fish, and olive oil. During a mean follow-up of 3.2 years, 998 subjects (12%) developed new-onset diabetes. Of the 7533 subjects without impaired fasting glucose at baseline, 2514 (33%) developed new-onset impaired fasting glucose or diabetes. Independent risk factors for new-onset impaired fasting glucose or diabetes included older age, hypertension, use of beta-blockers, lipid-lowering medications (protective) and diuretic use. Independent lifestyle risk factors for new-onset diabetes or impaired fasting glucose included higher BMI, greater BMI gain during follow-up, current smoking, a lower Mediterranean dietary score, and wine consumption >1 L/day. Inability to perform exercise testing, as surrogate to physical fitness status, was also associated with higher incidence of diabetes and impaired fasting glucose. As a result, patients with recent myocardial infarction had a higher incidence rate of impaired fasting glucose or diabetes compared with population-based cohorts. In the authors’ view, myocardial infarction may be considered as a prediabetes risk equivalent.
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