Impact of diabetes mellitus on the outcomes of patients with acute myocardial infarction during hospitalization

Objective:To investigate whether diabetes mellitus is an independent predictor of in-hospital death in patients with acute myocardial infarction(AMI).Method:A retrospective study was carried out in 2 136 patients with AMI including 485 diabetics and 1 651 nondiabetics.Baseline characteristics,therapeutic approaches and the occurrence rate of angina pectoris,reinfarction,heart failure and death during hospitalization were compared between diabetic and nondiabetic patients.To identify risk factors that are predictive of in-hospital death,multivariate logistic regression analysis was used.Result:Patients with diabetes mellitus were substantially older([65.5±10.3] vs [62.4±11.8]years,P0.01) and exhibited a high level of fasting glucose([10.4±3.2] vs [5.6±1.2] mmol/L,P0.01) than those without.Females(46.4% vs 24.8%,P0.01),patients with Killip class greater than or equal to Ⅲ(11.3% vs 5.8%,P0.01)were more common in diabetic than in nondiabetic patients.The prevalence of hypertension and hyperlipidemia in diabetic patients was higher than that in nondiabetic patients(49.9% vs 42.8%,P0.01;63.9% vs 58.7%,P0.05,respectively).Diabetic patients received reperfusion therapy including both thrombosis and primary PCI less frequently than nondiabetic patients within the first 12 hours after symptom onset(22.3% vs 30.6%,P0.01).Furthermore,beta receptor blockers were underused in diabetic patients during hospitalization(64.5% vs 70.5%,P0.05).An increased mortality was demonstrated in diabetic patients during the hospitalization phase of AMI(14.4% vs 5.9%,P0.01).The results of logistic regression demonstrated that age,hypertension,diabetes mellitus,fasting glucose,hyperlipidemia,Killip class of cardiac function,and administration of reperfusion therapy and beta receptor blockers were independent predictors of in-hospital death in patients with AMI.Conclusion:Diabetes mellitus is an independent predictor of in-hospital death in hospitalized patients with AMI.