Recent US Patterns and Predictors of Prevalent Diabetes among Acute Myocardial Infarction Patients

Abstract

Background. Diabetes mellitus (DM) confers high vascular risk and is a growing national epidemic. We assessed clinical characteristics and prevalence of diagnosed DM among patients hospitalized with acute myocardial infarction (AMI) in the US over the last decade. Methods. Data were obtained from all states within the US that contributed to the Nationwide Inpatient Sample. All patients admitted to hospitals between 1997 and 2006 with a primary discharge diagnosis of AMI were included. Time trends in the proportion of these patients with DM diagnosis were computed. Results. The portion of patients with comorbid diabetes among AMI hospitalizations increased substantially from 18% in 1997 to 30% in 2006 (P < .0001). Absolute numbers of AMI hospitalizations in the US decreased 8% (from 729, 412 to 672, 243), while absolute numbers of AMI hospitalizations with coexisting DM rose 51% ((131, 189 to 198, 044), both (P < .0001). Women with AMI were significantly more likely to have DM than similarly aged men, but these differences diminished with increasing age. Conclusion. Although overall hospitalizations for AMI in the US diminished over the last decade, prevalence of diabetes rose substantially. This may have important consequences for the future societal vascular disease burden.

Temporal trends in clinical characteristics of patients without known cardiovascular disease with a first episode of myocardial infarction

“…With a rise in obesity and persistent trend for a sedentary lifestyle, it further seems unlikely that the overall prevalence of DM has truly decreased over time. 18 Given the younger age at time of presentation, it is more likely that these patients have some degree of glucose intolerance and fit the criteria for prediabetes rather than DM.…”

HbA1C and its Correlation with Lipid Profile in Acute Myocardial Infarction

“…It has been recognized for some time that diabetics experience a greater mortality during the acute phase of myocardial infarction (MI) and a higher morbidity in the postinfarction period. 5 In acute coronary syndromes, glucose metabolism is modified, and stress hyperglycaemia commonly occurs secondary to increased catecholamine levels. 6 Due to stress hyperglycaemia, a method looking only at plasma glucose levels at the time of an AMI cannot be used to predict the prognosis.…”

Diabetes mellitus and the heart

“…Contemporary studies suggest that more than quarter of patients experiencing MI have comorbid DM, with secular analyses showing increasing co‐occurrence of DM (5,6). When prediabetic disorders (impaired glucose tolerate or impaired fasting glycaemia) are included, the majority of patients with clinically manifest ischaemic heart disease exhibit glucose dysregulation (Figure 1) (5,7).…”