Characteristics of patients with myocardial infarction, diabetes mellitus and chronic renal failure

Introduction. Patients with diabetes mellitus and acute myocardial infarction often present with multiple comorbidities, among which chronic kidney disease significantly complicates management and worsens prognosis. This study aimed to assess the impact of chronic kidney disease on clinical, echocardiographic, and coronary findings, as well as on outcomes in diabetic patients with acute myocardial infarction. Material and Methods. A total of 1,353 patients with diabetes mellitus and acute myocardial infarction were analyzed and stratified according to the presence or absence of chronic kidney disease. Descriptive and analytical statistical methods, including the Mann-Whitney U and ?2 tests, were applied to evaluate demographic, clinical, echocardiographic, and angiographic parameters, treatment modalities, hospital stay, and in-hospital mortality. Results. Chronic kidney disease was present in 38.4% of patients, predominantly in advanced stages (III-V). Patients with chronic kidney disease were older, more often female, hypertensive, and non-smokers. Echocardiography showed lower left ventricular ejection fraction, larger left atrial volume, and impaired diastolic function. Patients with chronic kidney disease more frequently presented with non-ST elevation myocardial infarction, had multiple coronary stenoses, lower blood pressure, higher heart rates, and worse Killip class. They were less likely to undergo percutaneous coronary intervention and experienced longer hospitalization and higher in-hospital mortality. Conclusion. In diabetic patients with acute myocardial infarction, chronic kidney disease is associated with worse clinical, echocardiographic, and angiographic profiles, as well as poorer in-hospital outcomes. These findings underline the importance of individualized management strategies for this particularly high-risk population.