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For 2,058 consecutive patients hospitalized for suspected acute myocardial infarction (AMI) but in whom AMI was later ruled out, we describe the prognosis with particular emphasis on diabetics. In all, a previous history of diabetes mellitus occurred in 290 (14%) of the patients. Compared with nondiabetics, they had a longer delay time between onset of symptoms and arrival in hospital. During 1 year of follow-up, their mortality rate was 28% compared with 14% for nondiabetics (p < 0.001), and their reinfarction rate was 20% compared with 10% for nondiabetics. More diabetics died in association with a fatal myocardial infarction and more frequently had ventricular fibrillation preceding death. With the exception of reinfarction, no clear difference in terms of morbidity was observed between the two groups. We conclude that the prognosis in diabetics in whom AMI is ruled out is poor, with between one-quarter and one-third not surviving 1 year.
Karlson et al. (Thu,) studied this question.