Key result
Post-MI diabetes care shows wide international variation, with SGLT2 inhibitor discharge prescription reaching ~55%.
Why the study?
Diabetes is a major risk factor for MI associated with adverse outcomes. This study used the EuroHeart infrastructure to describe contemporary baseline characteristics, comorbidities, and treatment patterns among MI patients, focusing on those with diabetes, across participating countries in 2024.
Observational (n=173,050)
Yes
In a large multinational registry of 173,050 MI patients in 2024, nearly one-third had diabetes, and despite high rates of invasive coronary management, the discharge prescription of cardioprotective GLP-1 receptor agonists and SGLT2 inhibitors varied widely across countries, indicating a clear opportunity to optimize post-MI secondary prevention.
High diabetes prevalence in large cardiac cohorts supports routine screening; leaves open optimal therapy integration pending prospective data.
Background Diabetes is an important and global health challenge and a risk factor for myocardial infarction (MI), which is associated with adverse outcomes. To support systematic improvements in cardiovascular care, many countries have established national quality registries to monitor patient characteristics, treatments and outcomes. The European Unified Registries on Heart Care Evaluation and Randomised Trials (EuroHeart) initiative provides an infrastructure for continuous prospective collection of harmonised clinical variables to support and improve the quality of cardiovascular care in Europe. Purpose To describe baseline characteristics, comorbidities and treatment patterns among patients with MI, with a focus on those with diabetes, in EuroHeart countries reporting data in 2024. Methods Continuous data on patients admitted with MI were collected in participating hospitals across 13 EuroHeart countries in 2024, using variables defined by the EuroHeart data standards. Data were submitted in aggregated form from England and Wales, Estonia, France, Hungary, Iceland, Ireland, Italy, Norway, Portugal, Romania, Singapore, Sweden and Switzerland. Variables included baseline characteristics, in-hospital care and discharge treatments. Individual patient-level data were aggregated at national level by age group, sex and diabetes status prior to central statistical analysis. Data are presented as proportions and means/medians to facilitate visual comparison. Results A total of 173,050 patients with MI were included in 2024 across 13 countries, of whom nearly 32% were women. Diabetes was present in 28% of patients. Those with diabetes were older (mean age 69 years) than those without diabetes (66 years) and had a substantially higher burden of comorbidities, including hypertension and chronic kidney disease (Figure 1). A high proportion of patients underwent coronary angiography (94%) and percutaneous coronary intervention (76%), irrespective of diabetes status. Similarly, only minor differences were observed in the prescription of antiplatelet agents, lipid-lowering therapy, and ACE inhibitors/ARBs between patients with and without diabetes. Among patients with diabetes, 54% (range 28–81%) received metformin, while cardioprotective glucose-lowering therapies were prescribed at discharge to 9% (2–25%) for glucagon-like peptide-1 receptor agonists (GLP-1 RA) and 55% (40–76%) for sodium-glucose cotransporter-2 (SGLT2) inhibitors, with variation between countries (Figure 2). Conclusions In 2024, nearly one-third of patients with MI in EuroHeart had diabetes, which was associated with older age and a higher burden of comorbidities. Despite similar use of coronary interventions and standard cardiovascular therapies between patients with and without diabetes, the prescription of GLP-1 RA and SGLT2 inhibitors varied widely across countries, highlighting opportunities to optimise diabetes management in patients with MI.Figure 1Figure 2
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Haider et al. (2026) conducted an observational in Myocardial infarction and diabetes (n=173,050). Diabetes mellitus vs. Patients without diabetes was evaluated on Baseline characteristics, comorbidities, in-hospital care, and discharge treatment patterns (including GLP-1 RA and SGLT2 inhibitor prescription). Diabetes affected 28% of MI patients, with wide cross-country variation in discharge prescription of GLP-1 RAs (9%, range 2-25%) and SGLT2 inhibitors (55%, range 40-76%).
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