{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:01:10Z","timestamp":1793314870105,"version":"4.5.0"},"reference-count":37,"publisher":"American Diabetes Association","issue":"1","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100010119","name":"Stiftelsen Dorothea Olivia, Karl Walter och Jarl Walter Perklens Minne","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010119","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002341","name":"Suomen Akatemia","doi-asserted-by":"publisher","award":["316664"],"award-info":[{"award-number":["316664"]}],"id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010113","name":"Wilhelm och Else Stockmanns Stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010113","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004212","name":"P\u00e4ivikki ja Sakari Sohlbergin S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004212","id-type":"DOI","asserted-by":"publisher"}]},{"name":"EVO governmental grants","award":["TYH2018207"],"award-info":[{"award-number":["TYH2018207"]}]},{"DOI":"10.13039\/100015736","name":"Folkh\u00e4lsanin Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015736","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010133","name":"Aarne Koskelon S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010133","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Liv och H\u00e4lsa Society"},{"DOI":"10.13039\/100010135","name":"Finska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010135","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006306","name":"Sigrid Juseliuksen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF OC0013659"],"award-info":[{"award-number":["NNF OC0013659"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013500","name":"Diabetestutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013500","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1,2]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To study prognosis after a first-ever myocardial infarction (MI) in type 1 diabetes, as well as how different MI- and diabetes-related factors affect the prognosis and risk of secondary cardiovascular events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>In this observational follow-up study of 4,217 individuals from the Finnish Diabetic Nephropathy (FinnDiane) Study with no prior MI or coronary revascularization, we verified 253 (6.0%) MIs from medical records or death certificates. Mortality from cardiovascular or diabetes-related cause was our main end point, whereas hospitalization due to heart failure, coronary revascularization, and recurrent MI were secondary end points, while accounting for death as a competing risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Of the individuals studied, 187 (73.9%) died during the median post-MI follow-up of 3.07 (interquartile range 0.02\u20138.45) years. Independent risk factors for cardiovascular and diabetes-related mortality were estimated glomerular filtration rate categories grade 3 (G3) (hazard ratio [HR] 3.27 [95% CI 1.76\u20136.08]), G4 (3.62 [1.69\u20137.73]), and G5 (4.03 [2.24\u20137.26]); prior coronary heart disease diagnosis (1.50 [1.03\u20132.20]); and older age at MI (1.03 [1.00\u20131.05]). Factors associated with lower mortality were acute revascularization (HR 0.35 [95% CI 0.18\u20130.72]) and subacute revascularization (0.39 [0.26\u20130.59]). In Fine and Gray competing risk analyses, kidney failure was associated with a higher risk of recurrent MI (subdistribution HR 3.27 [95% CI 2.01\u20135.34]), heart failure (3.76 [2.46\u20135.76]), and coronary revascularization (3.04 [1.89\u20134.90]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Individuals with type 1 diabetes have a high cardiovascular and diabetes-related mortality after their first-ever MI. In particular, poor kidney function is associated with high mortality and excessive risk of secondary cardiovascular events.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc22-1586","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T21:46:40Z","timestamp":1668808000000},"page":"197-205","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":17,"title":["Prognosis After First-Ever Myocardial Infarction in Type 1 Diabetes Is Strongly Affected by Chronic Kidney Disease"],"prefix":"10.2337","volume":"46","author":[{"given":"Patrik","family":"Smidtslund","sequence":"first","affiliation":[{"name":"1Folkh\u00e4lsan Institute of Genetics, Folkh\u00e4lsan Research Center, Helsinki, Finland"},{"name":"2Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"3Research Program in Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1192-348X","authenticated-orcid":false,"given":"Fanny","family":"Jansson Sigfrids","sequence":"additional","affiliation":[{"name":"1Folkh\u00e4lsan Institute of Genetics, Folkh\u00e4lsan Research Center, Helsinki, Finland"},{"name":"2Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"3Research Program in Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anni","family":"Ylinen","sequence":"additional","affiliation":[{"name":"1Folkh\u00e4lsan Institute of Genetics, Folkh\u00e4lsan Research Center, Helsinki, Finland"},{"name":"2Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"3Research Program in Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland"},{"name":"5Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Elonen","sequence":"additional","affiliation":[{"name":"1Folkh\u00e4lsan Institute of Genetics, Folkh\u00e4lsan Research Center, Helsinki, Finland"},{"name":"2Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"3Research Program in Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3568-9779","authenticated-orcid":false,"given":"Valma","family":"Harjutsalo","sequence":"additional","affiliation":[{"name":"1Folkh\u00e4lsan Institute of Genetics, Folkh\u00e4lsan Research Center, Helsinki, Finland"},{"name":"2Department of Nephrology, University of Helsinki and Helsinki University 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