Impact of diabetes mellitus on in-hospital death of patients with acute myocardial infarction.

Abstract

Objective To evaluate the clinical characteristics and in-hospital mortality of acute myocardial infarction patients (AMI) with diabetes mellitus (DM) and to analyze the risk factors of in-hospital mortality of AMI. Method A total of 1023 patients with diagnosis of AMI complicated with or without DM admitted between 2000 and 2004 were analyzed to find out the clinical characteristics, in-hospital complications and mortality. Of them, 164 (16.03%) were complicated with DM. The data were analyzed by using Mann-Whitney U or chi-square test. The multivariate logistic regression analysis was used to find out the risk factors of in-hospital mortality of patient with AMI. Results In comparison with non-DM patients, the females were predominant in number over males in the DM patient cohort (42.2% vs. 28.9%, P < 0.05), the incidence of hypertension (71.7% vs. 41.6%, P < 0.01) and rate of angina (57.3% vs. 48.3%, P < 0.06). The admission time of DM patients was delayed rather than that of non-DM patients. Coronary angiography revealed that the rate of three-vessel in-volved was higher in DM patients than in non-DM patients (48.4% vs. 25.4%, P < 0.05. During hospital stay, AMI patients with DM presented mar frequently with arrhythmias, pulmonary edema (18.9% vs. 10.5%, P <0.01) and increase in in-hospital mortality (17.7% vs. 9.2%, P < 0.01) compared with non-DM patients. Di-uretics (43.9% vs. 32%, P <0.01) and digitalis (27.4% vs. 16.8%, P <0.01) were more frequently used in DM patients rather than in non-DM patients. Compared to medication, primary coronary intervention (PCI) with placement of intra-vascular stent significantly decreased the mortality of DM patients (χ~2 = 4.536, P < 0.05).Logistic regression analysis showed DM was an independent risk factor for in-hospital mortality (OR = 2.109;95% CI:1.229-3.619). Conclusions AMI patients with DM exhibit more risk factors for in-hospital complications and higher mortality than those without DM.DM is an independent risk factor for in-hospital mortality of patients with AMI. Key words: Myocardial infarction; Diabetes mellitus; in-hospital mortality; Prognosis; Multiple factors analysis