In-hospital Outcome for Diabetic Patients with Acute Myocardial Infarction in the Thrombolytic Era

Abstract

A 3-year retrospective study was carried out at the Department of Cardiology, Aalborg Hospital, Denmark. The aim of the study was to investigate the in-hospital mortality and complications resulting from acute myocardial infarction in diabetic patients compared with non-diabetic patients in the thrombolytic era and to investigate the correlation between mortality and blood glucose levels in diabetic patients. All patients admitted to the study suffered acute myocardial infarctions. One hundred and twenty-three patients with diabetes and 856 patients without diabetes were included. Mortality was 13% (110 patients) in non-diabetic patients compared with 28% (34 patients) in diabetic patients (p = 0.00002). Eighty-nine patients with diabetes (72%) experienced heart failure or a worsening of heart failure compared with 424 patients without diabetes (50%), p = 0.00001. Twenty-eight diabetic patients (23%) had high-degree atrioventricular block, compared with only 99 non-diabetic patients (12%), p = 0.001. Atrial fibrillation developed in 35 patients with diabetes (28%) and in only 141 patients without diabetes (16%), p = 0.002. No difference was seen in occurrence of ventricular tachyarrhythmias. Diabetic patients with a fatal outcome had significantly higher blood glucose values at admission compared with diabetic patients who survived (17.1 +/- 8.3 vs 13.5 +/- 6.3 mmol/l; p = 0.034), and during hospitalization (85.7 +/- 26.0% of blood glucose values exceeding 10 mmol/l vs 64.5 +/- 33.1; p = 0.00065). In the thrombolytic era diabetic patients with acute myocardial infarction had a higher mortality and experienced more complications during hospitalization compared with non-diabetic patients, and diabetic patients with a fatal outcome had higher blood glucose levels compared with surviving diabetic patients.