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Hospital outcome of acute myocardial infarction in patients with and without diabetes mellitus
Author(s) -
Otter W.,
Kleybrink S.,
Doering W.,
Standl E.,
Schnell O.
Publication year - 2004
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2004.01114.x
Subject(s) - medicine , diabetes mellitus , myocardial infarction , microalbuminuria , angina , coronary care unit , cardiology , microangiopathy , disease , endocrinology
Abstract Aims To assess hospital mortality and morbidity in diabetic and non‐diabetic patients with acute myocardial infarction and to compare the results between the two groups. Methods All patients admitted in 1999 to the intensive care unit of the Schwabing City Hospital with diagnosis of acute myocardial infarction were assessed for hospital mortality and co‐morbidity. Results Three hundred and thirty patients with acute myocardial infarction were admitted. Of those, 126 (38%) were diabetic and 204 (62%) were non‐diabetic patients. Mortality within 24 h after admission was 13.5% in diabetic patients and 5.4% in non‐diabetic patients ( P < 0.01). Mortality during entire hospitalization was higher in diabetic than in non‐diabetic patients (29.4% vs. 16.2%; P = 0.004). Diabetic patients were resuscitated more frequently than non‐diabetic patients (24% vs. 11%, P < 0.01). In diabetic patients, heart rate at admission was increased (91 ± 27 vs. 82 ± 23/min; P < 0.01) and presence of angina pectoris was reported less frequently (59% ( n = 72) vs. 82% ( n = 167); P < 0.001). Preceding myocardial infarction, microalbuminuria, peripheral artery disease and arterial hypertension were more frequent in diabetic than in non‐diabetic patients. Diabetic patients demonstrated higher C‐reactive protein (CRP) levels than non‐diabetic patients (91.4 ± 78.2 mg/l vs. 45.2 ± 62.4 mg/l; P < 0.001). Conclusions In diabetic patients with acute myocardial infarction, early hospital mortality is increased and signs of cardiac autonomic dysfunction and microangiopathy are detected more frequently than in non‐diabetic patients. The need for advanced treatment strategies early in the course of diabetic patients with myocardial infarction is emphasized. Diabet. Med. 21, 183–187 (2004)