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. 2021 Mar;36(Suppl 1):S99-S113.
doi: 10.3904/kjim.2020.477. Epub 2021 Jan 12.

Sex differences in long-term clinical outcomes of acute myocardial infarction according to the presence of diabetes mellitus

Yu Ri Kim  1 , Myung Ho Jeong  1 , Youngkeun Ahn  1 , Ju Han Kim  1 , Young Joon Hong  1 , Min Chul Kim  1 , Kyung Hoon Cho  1 , Xiong Yi Han  1 ; other KAMIR-NIH Registry Investigators
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Sex differences in long-term clinical outcomes of acute myocardial infarction according to the presence of diabetes mellitus

Yu Ri Kim et al. Korean J Intern Med. 2021 Mar.

Abstract

Background/aims: This study compared long-term clinical outcomes between male and female acute myocardial infarction (AMI) patients with and without diabetes mellitus (DM).

Methods: From November 2011 to December 2015, 13,104 patients with AMI were enrolled in the Korea Acute Myocardial Infarction Registry National Institutes of Health (KAMIR-NIH) (4,458 diabetic patients and 8,646 non-diabetic patients). Propensity score matching (PSM) was used to reduce bias due to confounding variables. Following PSM, 2,046 diabetic patients, 1,023 males (69.8 ± 9.4 years) and 1,023 females (69.9 ± 9.4 years); and 3,412 non-diabetic patients, 1,706 males (70.0 ± 10.4 years) and 1,706 females (70.4 ± 10.8 years) were analyzed. Clinical outcomes were compared between male and female patients with and without diabetes over a 3-year clinical follow-up.

Results: In diabetic patients, mortality (21.1% vs. 21.5%, p = 0.813) and major adverse cardiac events (MACE) (30.6% vs. 31.4%, p = 0.698) were not significantly different between males and females. However, mortality (15.8% vs. 12.0%, p = 0.002) and MACE (20.8% vs. 15.6%, p < 0.001) were significantly higher in male non-diabetic patients than in female non-diabetic patients. The predictors of mortality for both males and females in the diabetic and non-diabetic groups were old age, heart failure, renal dysfunction, anemia, and no percutaneous coronary intervention.

Conclusion: The long-term clinical outcomes in AMI patients with DM did not significantly differ by sex. However, the mortality and MACE in non-diabetic male patients were higher than those in females.

Keywords: Diabetes mellitus; Myocardial infarction; Prognosis; Sex.

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Conflict of interest statement

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Kaplan–Meier curve for major adverse cardiac events (MACE) and mortality in diabetic patients with acute myocardial infarction. Cumulative rate of mortality (A) and MACE (B).
Figure 2
Figure 2
Kaplan–Meier curve for major adverse cardiac events (MACE) and mortality in non-diabetic patients with acute myocardial infarction. Cumulative rate of mortality (A) and MACE (B).
See this image and copyright information in PMC

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References

    1. Korea Centers for Disease Control. 2018 Disease Management White Paper. Cheongju (KR): KDCA; 2018.
    1. Korea Centers for Disease Control. 2017 Disease Management White Paper. Cheongju (KR): KDCA; 2017.
    1. Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham study. JAMA. 1979;241:2035–2038. - PubMed
    1. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:937–952. - PubMed
    1. Wei CC, Shyu KG, Cheng JJ, Lo HM, Chiu CZ. Diabetes and adverse cardiovascular outcomes in patients with acute coronary syndrome: data from Taiwan’s acute coronary syndrome full spectrum data registry. Acta Cardiol Sin. 2016;32:31–38. - PMC - PubMed

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