Decade-long trends in the characteristics, management and hospital outcomes of diabetic patients with ST-segment elevation myocardial infarction

Diab Vasc Dis Res. 2014 May;11(3):182-9. doi: 10.1177/1479164114524235. Epub 2014 Mar 11.

Abstract

Purpose: Our objectives were to describe recent trends in the characteristics and in-hospital outcomes in diabetic as compared with non-diabetic patients hospitalized with ST-segment elevation myocardial infarction (STEMI).

Methods: We reviewed the medical records of 2537 persons with (n = 684) and without (n = 1853) a history of diabetes who were hospitalized for STEMI between 1997 and 2009 at 11 medical centres in Central Massachusetts.

Results: Diabetic patients were more likely to be older, female and to have a higher prevalence of previously diagnosed comorbidities. Diabetic patients were more likely to have developed important in-hospital complications and to have a longer hospital stay compared with non-diabetic patients. Between 1997 and 2009, there was a marked decline in hospital mortality in diabetic (20.0%-5.6%) and non-diabetic (18.6%-7.5%) patients.

Conclusion: Despite reduced hospital mortality in patients hospitalized with STEMI, diabetic patients continue to experience significantly more adverse outcomes than non-diabetics.

Keywords: Diabetes; ST-segment elevation myocardial infarction; hospital prognosis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Age Factors
  • Aged
  • Angiotensin Receptor Antagonists / therapeutic use*
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Aspirin / therapeutic use
  • Body Mass Index
  • Case-Control Studies
  • Cohort Studies
  • Coronary Artery Bypass / trends
  • Diabetes Complications / mortality
  • Diabetes Complications / physiopathology
  • Diabetes Complications / therapy*
  • Diabetes Mellitus*
  • Female
  • Hospital Mortality / trends
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Length of Stay / trends
  • Male
  • Middle Aged
  • Myocardial Infarction / mortality
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy*
  • Percutaneous Coronary Intervention / trends
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Platelet Aggregation Inhibitors
  • Aspirin