Management and in-hospital outcome of patients with first episode of acute myocardial infarction : Impact of diabetes mellitus

The aim of this study is to compare clinical characteristics, management, complications, in-hospital outcome and mortality of diabetic and nondiabetic patients after the first episode of acute myocardial infarction (MI). This retrospective case-matched study included 60 diabetic and 55 non-diabetic...

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Bibliographic Details
Published in:Journal of the National Medical Association 2006-11, Vol.98 (11), p.1752-1757
Main Authors: ATMACA, Aysegul, DOGAN, Serkan, DAGDELEN, Selcuk, KABAKCI, Giray, KES, Sirri, NAZLI, Nasih, ERBAS, Tomris
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Aged
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Arrhythmias, Cardiac - epidemiology
Biological and medical sciences
Case-Control Studies
Diabetic Angiopathies - epidemiology
Diabetic Angiopathies - mortality
Diabetic Angiopathies - therapy
Female
General aspects
Hospitalization
Humans
Hypertension - epidemiology
Male
Medical sciences
Miscellaneous
Myocardial Infarction - drug therapy
Myocardial Infarction - epidemiology
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Public health. Hygiene
Public health. Hygiene-occupational medicine
Survival Analysis
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Summary:The aim of this study is to compare clinical characteristics, management, complications, in-hospital outcome and mortality of diabetic and nondiabetic patients after the first episode of acute myocardial infarction (MI). This retrospective case-matched study included 60 diabetic and 55 non-diabetic patients. Medical information about patients was retrieved from the hospital recordings. Diabetic patients were older, were more hypertensive and had more coronary artery disease history than nondiabetic patients. The frequency of use of acute reperfusion therapy modalities was not statistically different between the two groups. Diabetes was a significant determinant against the use of beta blockers (OR=0.26; 95% CI 0.06-0.95) but in favor of angiotensin converting enzyme inhibitors (OR=3.3; 95% CI 1.17-9.36), whereas diabetes did not influence the use of other drugs. Diabetic patients had more complications than nondiabetic patients (40.0% and 16.3%, respectively, p=0.005). In-hospital mortality rate for diabetic patients was comparable to nondiabetic patients (16.7% and 10.9%, respectively, p=0.373). Pharmaceutical treatment regimens, particularly beta blockers, are underutilized after acute MI in diabetic patients. More frequent use of these regimens will improve the high complication and mortality rates in diabetic patients as well as in nondiabetic patients.
ISSN:0027-9684
1943-4693