Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Age of diagnosis associated with age at first myocardial infarction in type 2 diabetes (#175)

Natalie Nanayakkara 1 , Jeffrey Lefkovits 2 , Andrew E Ajani 2 , Sanjeeva Ranasinha 3 , Peter G Colman 1 , Spiros Fourlanos 1
  1. Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, VIC, Australia
  2. Department of Cardiology, Royal Melbourne Hospital, Melbourne, VIC, Australia
  3. Monash Applied Research Stream, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia

Background

Type 2 diabetes (T2D) is increasingly common in younger patients1,2. Despite extensive literature documenting the 2-3 fold higher risk of myocardial infarction (MI) in type 2 diabetes patients, there is less data on the association between the age at T2D diagnosis and expected time course to sustaining a MI. The aim of this study was to determine the relationship between age at first MI, age at T2D diagnosis and duration of diabetes prior to MI.

Methods

Pre-specified clinical and demographic details for 500 consecutive T2D patients presenting to a metropolitan teaching hospital with a first MI were obtained from hospital and local doctor records. Logistic regression analysis was used to examine factors associated with age at first MI.

Results

The mean age at diabetes diagnosis was 55±14 years and age at first MI 62±14 years. A histogram in figure 1 depicts the distribution for age at first MI.  Both age at diabetes diagnosis (p<0.01) and duration of diabetes (p<0.01) were associated with age at first MI on uni-variable analysis. After adjustment for gender, hypertension, hypercholesterolaemia and smoking, age at diabetes diagnosis was independently associated with age at first MI (p<0.01) however duration of diabetes was not associated with age at first MI (p=0.95). Linear regression analysis revealed that every 1 year increase in age at diabetes diagnosis  was associated with a 0.86 months increase in age at first MI (p<0.01) (Figure 2).

Conclusions

These observations suggest patients developing diabetes at a younger age also have an earlier time course to their first myocardial infarct and may require more aggressive cardiovascular risk factor management and screening for coronary artery disease.1567-HistAgeatMI.jpg

Figure 1: Histogram of age at first myocardial infarction (MI). Line represents kernel density. 

1568-AgeatMIVAgeatDM.jpg

Figure 2: Age at first MI vs Age at DM diagnosis


  1. Hillier TA, Pedula KL. Characteristics of an adult population with newly diagnosed type 2 diabetes: the relation of obesity and age of onset. Diabetes care. 2001 Sep;24(9):1522-7.
  2. Mokdad AH, Ford ES, Bowman BA,et al. Diabetes trends in the US: 1990–1998. Diabetes Care 2000; 23: 1278–1283.