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Association of Diabetes Mellitus and Its Types with In-Hospital Management and Outcomes of Patients with Acute

Priyanka Sethupathi1, Andrija Matetić2, Vijay Bang3

  • 1Department of Cardiology, Royal Stoke Hospital, Stoke on Trent, United Kingdom.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|February 28, 2023
PubMed

Insights

Patients with diabetes mellitus (DM) face worse outcomes after acute myocardial infarction (AMI). Type 1 DM (T1DM) patients experienced higher mortality and bleeding, while Type 2 DM (T2DM) patients had increased stroke risk compared to non-DM individuals.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Diabetes mellitus (DM) is a significant risk factor for adverse outcomes following acute myocardial infarction (AMI).
  • Limited large-scale research exists on the distinct impacts of Type 1 DM (T1DM) and Type 2 DM (T2DM) on AMI outcomes.

Purpose of the Study:

  • To investigate the differential impact of T1DM and T2DM on in-hospital outcomes for patients experiencing AMI.
  • To compare adverse events, including mortality, major adverse cardiovascular and cerebrovascular events (MACCE), bleeding, and stroke, between DM subtypes and non-DM patients post-AMI.

Main Methods:

  • Analysis of adult AMI discharges from the National Inpatient Sample (October 2015 - December 2018).
  • Patients were stratified into T1DM, T2DM, and non-DM (NDM) groups.
  • Multivariable logistic regression was employed to assess associations between DM status and outcomes, adjusting for relevant factors.

Main Results:

  • T1DM patients exhibited significantly higher odds of MACCE, all-cause mortality, and major bleeding compared to NDM patients.
  • T2DM patients showed increased odds of MACCE and ischemic stroke relative to NDM patients.
  • Both T1DM and T2DM patients had lower odds of receiving percutaneous coronary intervention, though T2DM patients had higher utilization of composite revascularization.

Conclusions:

  • Diabetes mellitus is associated with worse in-hospital clinical outcomes for AMI patients.
  • Significant differences exist between T1DM and T2DM, with T1DM patients experiencing generally worse outcomes and less revascularization.
  • These findings highlight the need for tailored management strategies based on DM type in AMI patients.
Abstract

Keywords:
Acute myocardial infarctionDiabetes mellitusMACCEMortality

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