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Diabetes increases mortality risk after acute MI
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Adults with diabetes have higher mortality risk after an acute MI than those without diabetes, according to data published in the Journal of Epidemiology Community Health.
“These results provide robust evidence that diabetes is a significant, long-term population burden among patients who have had [an MI],” Chris Gale, MBBS, PhD, associate professor and consultant cardiologist at the Leeds School of Medicine, England, said in a press release. “We need to place greater focus on the long-term effects of diabetes in [MI] survivors.”
Chris Gale
Researchers analyzed data from 247 National Health Service hospitals in England and Wales that provided care for 703,920 adult patients (66% men) from 2003 to June 2013. Of that cohort, 120,568 (17.1%) patients had diabetes and there were 187,875 total deaths (26.7%) during 1.94 million person-years of follow-up. Unadjusted mortality rates were 35.8% in those with diabetes and 25.3% in those without.
The patients were stratified by STEMI (mean age, 66 years) vs. non-STEMI (mean age, 71 years). When adjusted for age, sex and year of acute MI, the researchers found diabetes to be linked to a 72% increase in mortality risk from STEMI (excess mortality rate ratio [EMRR] = 1.72; 95% CI, 1.66-1.79) and a 67% rise in mortality risk from non-STEMI (EMRR = 1.67; 95% CI, 1.63-1.71) compared with patients without diabetes.
Further adjustment for comorbidity, risk factors and CV treatments did not change the results.
“Patients with diabetes more often presented with [non-STEMI], and more frequently were comorbid,” the researchers wrote. “Patients with diabetes also more frequently had a loop diuretic, which likely reflected their nearly twofold higher prevalence of [HF].”
One study limitation, according to the researchers, was the unavailability of diabetes treatment in the United Kingdom during the cohort study.
In the release, Gale said there can be noticeable changes in clinical practice.
“The partnership between cardiologists, [general practitioners] and diabetologists needs to be strengthened,” he said. “We need to make sure we are using established medications as effectively as possible among high-risk individuals.” – by James Clark
Disclosure: The researchers report no relevant financial disclosures.
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