Comparing the Prognosis between Diabetic and Non-diabetic Post-acute Myocardial Infarction Patients in Groups of Sex and Age

Background: Diabetes Mellitus )DM) is major risk factor for cardiovascular diseases (CVD). DM patients have a double risk to die from CVD than the general population, regardless of age. The prognosis of CAD is worse in diabetic woman, but the weight of DM seems to “fade out” in diabetic over 75 years old.

Objective: comparing the prognosis between DM and non-DM post-Acute Myocardial Infarction (AMI) patients in groups of sex and age.

Methods: A retrospective study including the AMI patients (2002-2012) hospitalized in Soroka Medical Center. The study strata defined by sex and age. The primary outcome was up-to-10-years all-cause mortality. The prognosis of DM and non-DM patients within each strata was compared adjusting for the investigated baseline characteristics.

Results: The final cohort included 5629 patients, (mean age 61.3±12.8 years, 77.4% men, 64% STEMI, 35% severe CAD). The prevalence of DM is higher in women than men (57.7% vs. 42.3%, p<0.001). During the up-to-10-years follow-up 1627 patients died, (43.8% in DM vs. 16.2% of the non-DM patients, hazard ratio (HR)=3.3, p<0.001). After adjustment, DM patients had increased risk of all-cause mortality than non-DM (AdjHR=1.91; p<0.001). DM women were at increased risk for mortality, particularly in the 60-69 age group (AdjHR=4.6; p=0.003). DM was one of the most prominent risk factors in each stratum.

Conclusions: DM patients have an increased risk of mortality in all age groups. DM is an independent risk factor for mortality after AMI. The relative risk for mortality of DM was lower in elder age groups compared with young. DM women, particularly age 60-29, are at increased risk for mortality.