Acute myocardial infarction in diabetic patients

All patients hospitalized during a 3-year period with an acute myocardial infarction were followed for the occurrence of reinfarction or death. The patients with diabetes mellitus (n = 95) were compared with the non-diabetic population (n = 545). The diabetics had a higher mortality rate (relative death rate of 1.44 vs. 0.93, p less than 0.01) and a higher frequency of reinfarctions (18.9 vs. 10.8%, p = 0.04) than the non-diabetic population. A larger proportion of the diabetics had suffered a previous infarction, but the excess mortality was also present in those without a previous infarction. Established risk factors for death after myocardial infarction, such as age, infarct size, infarct localization and heart size, could not account for the difference in mortality. It is suggested that the increased mortality among the diabetics may be due to an increase in the rate of progression of the atherosclerotic heart disease.