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Open AccessArticle

Diabetes Mellitus and Vitamin D Deficiency: Comparable Effect on Survival and a Deadly Association after a Myocardial Infarction

1
Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and Department of Medical Surgical and Health Sciences, University of Trieste, 34100 Trieste, Italy
2
Azienda Ospedaliera di Perugia and University of Perugia, Cardiology and Cardiovascular Physiopathology, 06156 Perugia, Italy
3
Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), 34100 Trieste, Italy
4
Biostatistics Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34100 Trieste, Italy
5
Department of Medicine, University of Udine, 33100 Udine, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to the work.
J. Clin. Med. 2020, 9(7), 2127; https://doi.org/10.3390/jcm9072127
Received: 18 June 2020 / Revised: 2 July 2020 / Accepted: 3 July 2020 / Published: 6 July 2020
(This article belongs to the Section Cardiology)
Survivors after a myocardial infarction (MI), especially those with diabetes mellitus (DM), remain at high risk of further events. Identifying and treating factors that may influence survival may open new therapeutic strategies. We assessed the impact on prognosis of DM and hypovitaminosis D (hypovitD), alone or combined. In this prospective, observational study, 1081 patients were enrolled surviving an MI and divided into four groups according to their diabetic and VitD status. The primary end-point was composite of all-cause mortality, angina/MI and heart failure (HF). Secondary outcomes were mortality, HF and angina/MI. During a follow-up of 26.1 months (IQR 6.6–64.5), 391 subjects experienced the primary end-point. Patients with DM or hypovitD had similar rate of the composite end-point. Patients with only hypovitD or DM did not differ regarding components of composite end-point (angina p = 0.97, HF p = 0.29, mortality p = 0.62). DM and VitD deficiency had similarly adjusted risks for primary end-point (HR 1.3, 95%CI 1.05–1.61; HR 1.3, 95% CI 1.04–1.64). The adjusted HR for primary composite end-point for patients with hypovitD and DM was 1.69 (95%CI 1.25–2.29, p = 0.001) in comparison to patients with neither hypoD nor DM. In conclusion, DM and hypovitD, individually and synergistically, are associated with a worse outcome after MI. View Full-Text
Keywords: diabetes mellitus; vitamin D; hypovitaminosis D; mortality; heart failure; myocardial infarction; angina; prognosis; MACE; RAAS diabetes mellitus; vitamin D; hypovitaminosis D; mortality; heart failure; myocardial infarction; angina; prognosis; MACE; RAAS
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MDPI and ACS Style

Aleksova, A.; Ferro, F.; Gagno, G.; Padoan, L.; Saro, R.; Santon, D.; Stenner, E.; Barbati, G.; Cappelletto, C.; Rossi, M.; Beltrami, A.P.; Sinagra, G. Diabetes Mellitus and Vitamin D Deficiency: Comparable Effect on Survival and a Deadly Association after a Myocardial Infarction. J. Clin. Med. 2020, 9, 2127. https://doi.org/10.3390/jcm9072127

AMA Style

Aleksova A, Ferro F, Gagno G, Padoan L, Saro R, Santon D, Stenner E, Barbati G, Cappelletto C, Rossi M, Beltrami AP, Sinagra G. Diabetes Mellitus and Vitamin D Deficiency: Comparable Effect on Survival and a Deadly Association after a Myocardial Infarction. Journal of Clinical Medicine. 2020; 9(7):2127. https://doi.org/10.3390/jcm9072127

Chicago/Turabian Style

Aleksova, Aneta; Ferro, Federico; Gagno, Giulia; Padoan, Laura; Saro, Riccardo; Santon, Daniela; Stenner, Elisabetta; Barbati, Giulia; Cappelletto, Chiara; Rossi, Maddalena; Beltrami, Antonio P.; Sinagra, Gianfranco. 2020. "Diabetes Mellitus and Vitamin D Deficiency: Comparable Effect on Survival and a Deadly Association after a Myocardial Infarction" J. Clin. Med. 9, no. 7: 2127. https://doi.org/10.3390/jcm9072127

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