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Diabetes and Its Impact on Cardiogenic Shock Outcomes in Acute Myocardial Infarction with Polyvascular Disease: A

Marlon V Gatuz1, Rami Abu-Fanne1, Dmitry Abramov2

  • 1Department of Cardiology, Hillel Yaffe Medical Center, Hadera 3200003, Israel.

Biomedicines
|August 29, 2024
PubMed

Insights

Diabetes mellitus (DM) increases mortality and adverse events in acute myocardial infarction (AMI) patients with cardiogenic shock (CS) and polyvascular disease. This highlights the need for targeted care in this high-risk group.

Area of Science:

  • Cardiology
  • Endocrinology
  • Vascular Medicine

Background:

  • Diabetes mellitus (DM) exacerbates cardiovascular risks, especially in acute myocardial infarction (AMI) with cardiogenic shock (CS).
  • Polyvascular disease further elevates prognosis challenges due to advanced atherosclerosis and comorbidities.
  • This study examines the combined effect of DM and polyvascular disease on AMI patients experiencing CS.

Purpose of the Study:

  • To investigate the impact of diabetes mellitus on outcomes in patients with acute myocardial infarction complicated by cardiogenic shock and polyvascular disease.
  • To analyze the association between diabetes status and in-hospital adverse events, mortality, and cerebrovascular accidents in this specific patient cohort.

Main Methods:

  • Analysis of 39,140 patients with AMI, CS, and polyvascular disease from the National Inpatient Sample database.
  • Stratification of patients based on diabetes status (DM vs. non-DM).
  • Multivariable logistic regression to assess in-hospital outcomes, including MACCE, mortality, CVA, and bleeding, adjusting for baseline characteristics.

Main Results:

  • 54% of the study population had DM; these patients were younger and more likely to be female.
  • Adjusted analysis revealed a 17% increased mortality risk in patients with DM (aOR 1.17, 95% CI: 1.11-1.23).
  • Patients with DM also had a higher risk of major adverse cardiovascular and cerebrovascular events (aOR 1.05, 95% CI: 1.01-1.10).

Conclusions:

  • Diabetes mellitus significantly worsens outcomes for patients with AMI, CS, and polyvascular disease.
  • DM is associated with increased mortality, longer hospital stays, and elevated healthcare costs in this population.
  • Findings emphasize the necessity for tailored interventions and specialized care strategies for high-risk patients with DM, AMI, CS, and polyvascular disease.
Abstract

Keywords:
acute myocardial infarctioncardiogenic shockdiabetes mellitusoutcomespoly-vascular disease

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