3-year mortality after acute myocardial infarction in patients with different diabetic status.

INTRODUCTION: The prevalence of diabetes mellitus (DM) in patients with myocardial infarction (MI) is estimated at about 25%. Short and long-term prognoses are worse in DM and hyperglycemia compared with non-diabetics. OBJECTIVES: Our aim was to analyze the impact of DM and transient hyperglycemia on in-hospital complications and long-term outcomes in MI patients. PATIENTS AND METHODS: We evaluated a prospective cohort of 58,394 MI patients in the Polish Registry of Acute Coronary Syndrome in terms of in-hospital complications and 30-day, 12-month, and 36-month outcomes between 2009-2012. RESULTS: Type 1 and 2 DM patients underwent invasive diagnostic and therapeutic procedures less frequently than non-diabetics, transient hyperglycemics and new-onset DM patients (P <0.001). Type 2 DM was associated with a significantly higher risk of MI complicated by cardiogenic shock. The rates of pulmonary edema in transient hyperglycemic and DM groups were two times higher than in the non-diabetic group (P <0.001). Type 1 and 2 DM were associated with a significantly higher risk of death. Unadjusted three-year all-cause death rates in patients with type 1 DM, type 2 DM, transient hyperglycemia, new-onset diabetes and non-diabetes were 26.8%, 25.6%, 18.5%, 17.9% and 16.2%. Hazard ratio (95%CI) adjusted for age, sex, clinical characteristics and revascularization were 1.49 (1.12-2.00), 1.20 (1.14-1.27), 0.94 (0.67-1.31), 0.66 (0.34-1.28), respectively. CONCLUSIONS: Type 1 and 2 DM is associated with elevated in-hospital and long-term mortality rates after MI. Diabetics and patients with transient hyperglycemia are more likely to develop significant in-hospital complications compared with non-diabetics. No significant differences in acute mechanical complications were noted between populations.