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Background  Case‐fatality rates in acute myocardial infarction ( AMI ) have significantly decreased; however, the prevalence of diabetes mellitus ( DM ), a risk factor for  AMI , has increased. The purposes of the present study were to assess the prevalence and clinical impact of  DM  among patients hospitalized with  AMI  and to estimate the impact of important clinical characteristics associated with in‐hospital mortality in patients with  AMI  and  DM .    Methods and Results  We used the National Inpatient Sample to estimate trends in  DM  prevalence and in‐hospital mortality among 1.5 million patients with  AMI  from 2000 to 2010, using survey data‐analysis methods. Clinical characteristics associated with in‐hospital mortality were identified using multivariable logistic regression. There was a significant increase in  DM  prevalence among  AMI  patients (year 2000, 22.2%; year 2010, 29.6%,  P  trend <0.0001).  AMI  patients with  DM  tended to be older and female and to have more cardiovascular risk factors. However, age‐standardized mortality decreased significantly from 2000 (8.48%) to 2010 (4.95%) ( P  trend <0.0001).  DM  remained independently associated with mortality (adjusted odds ratio 1.069, 95%  CI  1.051 to 1.087;  P <0.0001). The adverse impact of  DM  on in‐hospital mortality was unchanged over time. Decreased death risk over time was greatest among women and elderly patients. Among younger patients of both sexes, there was a leveling off of this decrease in more recent years.    Conclusions  Despite increasing  DM  prevalence and disease burden among  AMI  patients, in‐hospital mortality declined significantly from 2000 to 2010. The adverse impact of  DM  on mortality remained unchanged overall over time but was age and sex dependent.

journal of the american heart association

In‐Hospital Mortality Among Patients With Type 2 Diabetes Mellitus and Acute Myocardial Infarction: Results From the National Inpatient Sample, 2000–2010