Key result
Diabetes linked to ~54% higher 10-year all-cause mortality after STEMI.
Why the study?
Diabetes influences the quality of care and long-term outcomes in contemporary STEMI cohorts, but detailed nationwide data were lacking.
Does diabetes status and quality of care affect long-term mortality in adults hospitalized with STEMI?
Cohort (n=283,658)
Yes
Does diabetes status and quality of care affect long-term mortality in adults hospitalized with STEMI?
Patients with diabetes presenting with STEMI experience lower quality of care and higher long-term mortality, though excellent inpatient care significantly reduces this mortality risk.
Answers are grounded in this paper and cite their sources.
Excellent care may mitigate excess diabetic STEMI mortality; extends cohort associations but leaves causal effects and practice change open.
AIMS: This study aimed to assess how diabetes influences the quality of care and longer-term outcomes in contemporary STEMI cohorts. METHODS: We analysed 283,658 adults hospitalised with STEMI from the United Kingdom Myocardial Ischaemia National Audit Project (MINAP) registry between 2005 and 2019. This was linked with Office of National Statistics data to provide out of hospital mortality outcomes. We compared longer-term outcomes depending on diabetes status and assessed the effect of quality of care using the opportunity-based quality-indicator score (OBQI). RESULTS: Individuals with diabetes were older (median age 68.7 vs. 65.5), underwent percutaneous coronary intervention less frequently (60 % vs. 63 %) and were less likely to achieve a door-to-balloon time of < 60 min (69 % vs. 75 %) or < 120 min (89 % vs. 92 %). Their adjusted all-cause mortality risk was higher during follow-up, from 30 days (HR: 1.49, CI: 1.44-1.54), to up to 10 years of follow up (HR: 1.54, CI: 1.52-1.57), compared to individuals without diabetes. Excellent inpatient care was associated with lower mortality rates within individuals with diabetes (Diabetes: HR 0.56, CI: 0.50-0.64, No diabetes: HR 0.62, CI: 0.58-0.67). CONCLUSIONS: Individuals with diabetes have a higher risk of long-term mortality after STEMI. They experience delays in angiography and receive lower quality inpatient care.
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Cole et al. (2025) conducted a cohort in ST-segment myocardial infarction (STEMI) (n=283,658). Diabetes mellitus vs. No diabetes was evaluated on All-cause mortality at up to 10 years of follow-up (HR 1.54, 95% CI 1.52-1.57). Diabetes mellitus was associated with a higher risk of all-cause mortality at up to 10 years of follow-up in adults hospitalized with STEMI compared to no diabetes.
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