Newly diagnosed and previously known diabetes mellitus and short-term outcomes in patients with acute myocardial infarction

Abstract

Previously known DM, but not newly diagnosed DM, was an independent predictor for short-term MACE in patients with STEMI. To reduce the incidence of short-term MACE and the detrimental effects of stress hyperglycemia after STEMI, intensive insulin therapy should be provided to diabetic patients with STEMI.

Long-term Prognosis and Clinical Characteristics of Patients with Newly Diagnosed Diabetes Mellitus Detected after First Acute Myocardial Infarction: from KAMIR-NIH Registry

“…Because the frequency of new-DM was higher in patients with AMI and since DM status at baseline affects clinical outcomes, prognosis evaluation should consider DM status. 4) 5) The prevalence of new-DM was reported to be 3.8%–17.0% among patients with AMI. Data sets from the Cleveland Clinic, Valliant, HORIZONS-AMI, and Tian et al's studies 5) define 8.0%, 4.0%, 3.8%, and 17.0% of patients with AMI as new-DM, respectively.…”

“… 4) 5) The prevalence of new-DM was reported to be 3.8%–17.0% among patients with AMI. Data sets from the Cleveland Clinic, Valliant, HORIZONS-AMI, and Tian et al's studies 5) define 8.0%, 4.0%, 3.8%, and 17.0% of patients with AMI as new-DM, respectively. 4) 8) 23) Therefore, all patients with AMI should be screened for DM.…”

“… 2) 3) Since the incidence of newly diagnosed DM (new-DM) is high in patients with AMI, it is recommended that all patients with AMI be screened for DM. 4) 5) Several studies evaluated the role of DM as a risk factor in patients with AMI. Among known risk factors, such as age, sex, and angiographic findings, DM is an important independent predictor of mortality in patients with AMI.…”

“… 4) Meanwhile, the Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial also suggested that patients with new-DM have a similarly poor prognosis after AMI. 8) However, Tian et al 5) reported that known-DM, but not new-DM, was an independent predictor for short-term (30-day) mortality and major adverse cardiac events (MACEs) in patients with ST-segment elevation myocardial infarction (STEMI). While DM status is recognized as an important factor affecting the risk of cardiovascular events in patients with AMI, controversy remains as to the exact role and extent of this influence.…”

“…The VALIANT study was performed in 2003 and fewer than 20% of enrolled patients underwent percutaneous coronary intervention (PCI). The HORIZONS-AMI study only enrolled patients with STEMI, and Tian et al's study 5) had relatively short-term follow-up.…”