Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2021 Dec 14:12:797049.
doi: 10.3389/fendo.2021.797049. eCollection 2021.

Does Diabetes Mellitus Increase the Short- and Long-Term Mortality in Patients With Critical Acute Myocardial Infarction? Results From American MIMIC-III and Chinese CIN Cohorts

Shiqun Chen  1 , Zhidong Huang  1 , Liling Chen  2 , Xiaoli Zhao  3   4 , Yu Kang  1 , Wenguang Lai  1 , Xiaozhao Lu  1 , Yang Zhou  1 , Yibo He  1 , Haozhang Huang  1 , Qiang Li  1 , Jin Liu  1 , Yan Liang  5 , Shaohong Dong  6 , Ning Tan  1 , Yong Liu  1 , Jiyan Chen  1
Affiliations
Clinical Trial

Does Diabetes Mellitus Increase the Short- and Long-Term Mortality in Patients With Critical Acute Myocardial Infarction? Results From American MIMIC-III and Chinese CIN Cohorts

Shiqun Chen et al. Front Endocrinol (Lausanne). .

Abstract

Background: The harmful effect of diabetes mellitus (DM) on mortality in patients with acute myocardial infarction (AMI) remains controversial. Furthermore, few studies focused on critical AMI patients. We aimed to address whether DM increases short- and long-term mortality in this specific population.

Methods: We analyzed AMI patients admitted into coronary care unit (CCU) with follow-up of ≥1 year from two cohorts (MIMIC-III, Medical Information Mart for Intensive Care III; CIN, Cardiorenal ImprovemeNt Registry) in the United States and China. Main outcome was mortality at 30-day and 1-year following hospitalization. Kaplan-Meier curves and Cox proportional hazards models were constructed to examine the impact of DM on mortality in critical AMI patients.

Results: 1774 critical AMI patients (mean age 69.3 ± 14.3 years, 46.1% had DM) were included from MIMIC-III and 3380 from the CIN cohort (mean age 62.2 ± 12.2 years, 29.3% had DM). In both cohorts, DM group was older and more prevalent in cardio-renal dysfunction than non-DM group. Controlling for confounders, DM group has a significantly higher 30-day mortality (adjusted odds ratio (aOR) (95% CI): 2.71 (1.99-3.73) in MIMIC-III; aOR (95% CI): 9.89 (5.81-17.87) in CIN), and increased 1-year mortality (adjusted hazard ratio (aHR) (95% CI): 1.91 (1.56-2.35) in MIMIC-III; aHR (95% CI): 2.62(1.99-3.45) in CIN) than non-DM group.

Conclusions: Taking into account cardio-renal function, critical AMI patients with DM have a higher 30-day mortality and 1-year mortality than non-DM group in both cohorts. Further studies on prevention and management strategies for DM are needed for this population.

Clinical trial registration: clinicaltrials.gov, NCT04407936.

Keywords: acute myocardial infarction; critical; diabetes mellitus (DM); long-term mortality; short-term mortality.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Patient flow diagram of MIMIC-III and CIN.
Figure 2
Figure 2
Summary graph of the role of DM in patients with critical AMI in the MIMIC-III and CIN cohort. *Odds ratio. †Hazard ratio.
Figure 3
Figure 3
Kaplan-Meier curves for all-cause mortality in patients with critical AMI with and without DM. (A) 1-year mortality among patients with critical AMI with and without DM in MIMIC-III. (B) 1-year mortality among patients with critical AMI with and without DM in CIN.
See this image and copyright information in PMC

References

    1. Ahmed B, Davis HT, Laskey WK. In-Hospital Mortality Among Patients With Type 2 Diabetes Mellitus and Acute Myocardial Infarction: Results From the National Inpatient Sample, 2000-2010. J Am Heart Assoc (2014) 3(4):e001090. doi: 10.1161/JAHA.114.001090 - DOI - PMC - PubMed
    1. Arnold SV, Lipska KJ, Li Y, McGuire DK, Goyal A, Spertus JA, et al. . Prevalence of Glucose Abnormalities Among Patients Presenting With an Acute Myocardial Infarction. Am Heart J (2014) 168(4):466–70.e1. doi: 10.1016/j.ahj.2014.06.023 - DOI - PMC - PubMed
    1. Gandhi GY, Roger VL, Bailey KR, Palumbo PJ, Ransom JE, Leibson CL. Temporal Trends in Prevalence of Diabetes Mellitus in a Population-Based Cohort of Incident Myocardial Infarction and Impact of Diabetes on Survival. Mayo Clin Proc (2006) 81(8):1034–40. doi: 10.4065/81.8.1034 - DOI - PubMed
    1. Donahoe SM, Stewart GC, McCabe CH, Mohanavelu S, Murphy SA, Cannon CP, et al. . Diabetes and Mortality Following Acute Coronary Syndromes. JAMA (2007) 298(7):765–75. doi: 10.1001/jama.298.7.765 - DOI - PubMed
    1. Bauters C, Lemesle G, de Groote P, Lamblin N. A Systematic Review and Meta-Regression of Temporal Trends in the Excess Mortality Associated With Diabetes Mellitus After Myocardial Infarction. Int J Cardiol (2016) 217:109–21. doi: 10.1016/j.ijcard.2016.04.182 - DOI - PubMed

Publication types

MeSH terms

Associated data