Diabetic patients and myocardial infarction

The investigation comprised 832 consecutive hospitalized patients with acute myocardial infarction (AMI). The prevalence of diabetes mellitus among the AMI-patients was 9.7 % and is significantly higher than in an age-matched population where the prevalence is about 6.1 % (p<0.05). The prevalence was higher for women than for men (14.9 % versus 7.6 %). The risk of AMI was found to be about 4 times higher among IDDM than among nondiabetics(p<0.05), whereas the risk for non-insulin dependent diabetics was only slightly increased (p<0.05). The mortality rate from AMI within the first month was 20.2 % for non-diabetics while 42 % of the diabetics died from their myocardial infarction (p<0.001). A specially high mortality rate of 51.6% was found among non-insulin dependent women. The investigation show further that patients in a poor diabetic state, both in the years prior to the AMI and at the time of hospitalization in the coronary care unit, had a significantly higher mortality rate (p<0.05). We therefore conclude that diabetes mellitus disposes to AMI and that the mortality rate of AMI is significantly increased among diabetics. A poor metabolic regulation of the diabetes seems to aggravate the prognosis of AMI.