Abstract
Type 1 diabetes mellitus (T1D) is associated with an increased cardiovascular risk. We aimed to investigate the influence of T1D on myocardial infarction (MI) patients' mortality. The German nationwide inpatient sample 2005-2016 was used for statistical analysis. Hospitalized MI patients were stratified for T1D and impact of T1D on in-hospital outcomes was investigated. In total, 3,307,703 hospitalizations of MI patients (37.6% females, 56.8% aged ≥70 years) were counted in Germany 2005-2016 and included in this analysis. In 18,625 (0.6%) of the cases additionally T1D was coded. Overall, 410,737 (12.4%) in-hospital deaths occurred within the investigation period. MI patients with T1D were younger (64.0 [IQR 52.0-75.0] vs. 73.0 [62.0-81.0] years, P<0.001), more often female (38.7% vs. 37.6%, P<0.001) and obese (13.2% vs. 9.3%, P<0.001). Comorbidities like peripheral arterial (14.2% vs. 6.4%, P<0.001) and kidney disease (38.5% vs. 27.2%, P<0.001) were more prevalent in MI patients with T1D. T1D was an independent risk factor for in-hospital death (OR 1.23 [95%CI 1.18-1.29], P<0.001), recurrent MI (OR 1.56 [95%CI 1.35-1.80], P<0.001), and stroke (OR 1.75 [95%CI 1.63-1.88], P<0.001). While percutaneous coronary intervention (PCI, 37.8% vs. 42.0%, P<0.001) was less often, coronary artery bypass grafting (CABG, 7.4% vs. 4.6%, P<0.001) was more often performed in MI patients with T1D, confirmed by regression analysis (PCI: OR 0.66 [95%CI 0.64-0.68], P<0.001; CABG: OR 1.54 [95%CI 1.45-1.63], P<0.001). T1D represents an important and independent risk factor for mortality in MI patients. The results emphasize the high vulnerability of T1D patients who suffer from MI.
Published Version
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