Diabetes Mellitus and Acute Myocardial Infarction: Impact on Short and Long-Term Mortality

Abstract

Diabetes mellitus (DM) is an important risk factor for acute myocardial infarction (AMI) and a frequent co-morbidity in patients hospitalized with AMI, being present in about 30% of cases. Although current treatment of AMI has considerably improved survival in both patients with and without DM, the presence of DM still doubles the case fatality rate during both the acute phase of AMI and at long-term follow-up. This higher mortality risk of DM patients strongly indicates a particular need for better treatment options in these patients and suggests that intensive medical treatment, prolonged surveillance, and stringent control of other risk factors should be carefully pursued and maintained for as long as possible in them.In this review, we will focus on the close association between DM and in-hospital and long-term mortality in AMI patients. We will also aim at providing current evidence on the mechanisms underlying this association and on emerging therapeutic strategies, which may reduce the traditional mortality gap that still differentiates AMI patients with DM from those without.

Keywords: Acute hyperglycemia; Acute myocardial infarction; Diabetes mellitus; In-hospital mortality; Long-term mortality; Non-ST-elevation myocardial infarction; Percutaneous coronary intervention; Pre-diabetes mellitus; ST-elevation myocardial infarction; Unknown diabetes mellitus.