Key result
Coexisting diabetes mellitus independently increased the risk of in-hospital mortality in young (HR 2.543) and male (HR 1.469) patients with acute myocardial infarction and renal dysfunction.
Why the study?
The prognostic impact of coexisting diabetes mellitus on mortality in patients with acute myocardial infarction complicating renal dysfunction remained ill-defined.
Does coexisting diabetes mellitus increase in-hospital mortality in patients with acute myocardial infarction complicating renal dysfunction?
Cohort
Does coexisting diabetes mellitus increase in-hospital mortality in patients with acute myocardial infarction complicating renal dysfunction?
Hazard Ratio: 2.543
Diabetes mellitus significantly increases the risk of in-hospital mortality in young (<65 years) and male patients with AMI and renal dysfunction, highlighting the need for targeted management in these subgroups.
May identify young male AMI patients with renal dysfunction for closer monitoring; hypothesis-generating for age- and sex-specific risk models.
BACKGROUND: Patients with acute myocardial infarction (AMI) complicating renal dysfunction (RD) are recognized as being at high risk. Although diabetes mellitus (DM) is a major cause of RD, the prognostic impact of coexisting DM on mortality in patients with AMI complicating RD is ill-defined. This study compared the prognostic impact of coexisting DM in patients with AMI complicating RD according to both age and sex. METHODS: ). Multivariable Cox regression analysis was performed to investigate the effects of DM on in-hospital mortality. RESULTS: Statistically significant interactions between age and DM and between sex and DM for in-hospital mortality were revealed in the entire cohort. Coexisting DM was identified as an independent risk factor for in-hospital mortality (hazard ratio [HR], 2.543) in young (aged <65 years), but not old (aged ≥65 years), patients. DM was identified as an independent risk factor (HR, 1.469) in male, but not female, patients. Kaplan-Meier survival curves showed that DM correlated with significantly low survival rates in patients that were young or male as compared to those who were old or female. CONCLUSIONS: There were significant differences in the prognostic impact of DM on in-hospital mortality between young and old as well as male and female patients with AMI complicating RD. These results have implications for future research and the management of patients with DM, RD, and AMI comorbidities.
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Matsushita et al. (2023) conducted a cohort in Acute myocardial infarction complicating renal dysfunction. Diabetes mellitus vs. No diabetes mellitus was evaluated on In-hospital mortality (HR 2.543). Coexisting diabetes mellitus independently increased the risk of in-hospital mortality in young (HR 2.543) and male (HR 1.469) patients with acute myocardial infarction and renal dysfunction.
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