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Bönner, Philipp Christian (2014): Risikoprädiktoren für kardiovaskuläre und zerebrovaskuläre Mortalität bei Diabetes. Dissertation, LMU München: Faculty of Medicine



Recent epidemiologic studies suggest that patients with diabetes mellitus suffer from increased hospital mortality after myocardial infarction and stroke. The aim of our analysis was to compare the hospital outcome of diabetic and non-diabetic patients with cardiovascular events and to analyse the relevant risk predictors. Therefore data of the Schwabing Myocardial Infarction Registry from 1999 to 2004, the Schwabing stroke register from 2003/2004, and the Pasing stroke register from 2007/2008 were assessed. Overall, these are 3171 recorded patients, of which 1087 were diabetic patients (34.3%) and 2084 non-diabetic patients (65.7%). Diabetic patients showed, apart from CRP, comparable risk predictors (GFR OR 4.2, CI 1.7-10.6, p<0.005; heart rate OR 2.1, CI 1.1-4.0, p=0.025; hypertension OR 0.3, CI 0.2-0.6, p<0.001) as non-diabetic patients (CRP OR 4.5, CI 2.3-8.8, p<0.001; GFR OR 3.8, CI 1.8-8.1, p<0.001; heart rate OR 2.7, CI 1.6-4.9, p<0.001; hypertension OR 0.5, CI 0.3-0.8, p<0.01). In the diabetic group, the frequency of these predictors was, however, significantly higher. Hypertension on admission appeared as a favourable prognostic factor. This has also been demonstrated in previous studies in the ICU. Whether potential pre-treatment or higher blood-pressure levels per se may contribute to the observation requires further investigations. For the clinical practice we can draw the conclusion that patients with the parameters found here increased need special attention on admission and during the treatment.