A systematic review and meta-regression of temporal trends in the excess mortality associated with diabetes mellitus after myocardial infarction

Long‐term mortality after acute myocardial infarction among individuals with and without diabetes: A systematic review and meta‐analysis of studies in the post‐reperfusion era

“…It is possible that in older patients factors related to both longer duration and severity of diabetes independently contribute to increased risk of cardiovascular events and consequent long‐term mortality . In line with previous reports, our findings of subgroup analyses support the notion that the gap in survival after AMI between patients with and without diabetes still persists in the modern treatment era . That we found no difference in the adverse impact of diabetes among cohorts with different proportions of men perhaps supports the growing body of evidence that diabetes attenuates any gender‐related survival benefits in women …”

“…Another meta‐analysis of 11 trials involving 6298 patients with STEMI treated with stents showed all‐cause mortality at a mean of 3.3 years being 76% higher in patients with diabetes compared to those without . In a more recent meta‐analysis of 61 studies, assessing mortality at 6 to 12 months after index AMI or ACS, people with diabetes had 86% higher mortality on univariate analysis compared with those without . Unlike these previous meta‐analyses, our findings are based on a much larger sample size and greater event numbers, and involve both unselected patients managed in real‐world practice from the cohort studies, as well as selected patients managed in the highly controlled environment of RCTs.…”

“…7 In a more recent meta-analysis of 61 studies, assessing mortality at 6 to 12 months after index AMI or ACS, people with diabetes had 86% higher mortality on univariate analysis compared with those without. 81 Unlike these previous meta-analyses, our findings are based on a much larger sample size and greater event numbers, and involve both unselected patients managed in real-world practice from the cohort studies, as well as selected patients managed in the highly controlled environment of RCTs. The present report confirms the findings of these previous meta-analyses and extends them to a broader group of patients with AMI followed up for a much longer period of up to 20 years.…”

Four varieties of diabetes mellitus in acute myocardial infarction

“…Nevertheless, a short-term 4 and a long-term mortality risk in the AMI patients with DM is almost doubled in comparison with the nondiabetic AMI patients 2,4,7 . A systematic review and meta-regression of 1,614,174 AMI, or ACS patients showed that the patients with DM (n = 432,066) had the odds ratio (OR) [95% CI] of 1.66 [1.59-1.74] (p < 0.0001) for early mortality, and of 1.86 [1.75-1.97] (p < 0.0001) for 6-12 months mortality in comparison with 1,182,108 nondiabetic patients 2 .…”

“…It is believed that 387 million patients (> 8% of the global population) have diabetes mellitus (DM), and almost one half of them are unaware of their diagnosis 1 . DM is very important risk factor for acute myocardial infarction (AMI) 2 . The patients with DM have a two-to four-fold increased risk of developing cardiovascular (CV) disease 3 , three-fold for the acute coronary syndrome (ACS) 4 , and they experience the CV events 15 years earlier than the general population 4,5 .…”