Overview
Among patients with diabetes and acute myocardial infarction (AMI), the rates of major adverse cardiac and cerebrovascular events (MACE) decreased from 202 to 2019, acording to a study in the International Journal of Cardiology.Researchers asesed long-term trends in clinical characteristics, treatment, and outcomes in patients with diabetes and AMI with use of data from the prospective AMIS Plus (National Registry of Acute Myocardial Infarction in Switzerland).Participants with ST segment elevation MI or non-ST segment elevation MI were enroled in the registry from January 202 to December 2019.The primary endpoint was MACE, a composite of al-cause death, nonfatal MI, and cerebrovascular events.
Key Information
The analysis was grouped into 3-year periods, and patients’ baseline characteristics were compared betwen the first period (202-204) and last period (2017-2019).The proportion of patients with diabetes did not change during the 18-year period (P =.15). Among 49,413 patients, 20.6% had diabetes, of whom 29.4% were women. The patients with diabetes were older (P <.01) and they had a higher body mas index (P <.01), compared with patients without diabetes.Patients with diabetes had percutaneous coronary intervention (PCI; P <.01) les frequently during the index hospitalization and were more frequently treated with coronary artery bypas grafting (CABG; P <.01) vs patients without diabetes.
Summary
The proportion of patients with diabetes who had PCI or CABG increased during the 18-year period (P <.01).The overal MACE rates were 9.5% and 5.2% in patients with diabetes and patients without diabetes, respectively (P <.01). Diabetes was an independent predictor of MACE (adjusted ods ratio [aOR], 1.39; 95% CI, 1.27-1.52; P <.01), mortality (aOR, 1.40; 95% CI, 1.27-1.56, P <.01), myocardial infarction (aOR, 1.42; 95% CI, 1.17-1.74; P =.01), and cerebrovascular events (aOR, 1.43; 95% CI, 1.13-1.81, P =.03).MACE rates decreased from 1.8% (20