Diabetics with Acute Myocardial Infarction Have Higher Mortality

MedicalResearch.com Interview with:
Jorge F. Saucedo MD
Allstate Foundation, Judson B. Branch Chair of Cardiology
Head, Division of Cardiology
Co-Director Cardiovascular Institute
NorthShore University HealthSystem
Clinical Professor of Medicine
University of Chicago Pritzker School of Medicine

Talla A. Rousan, MD
Oklahoma City, OK.
First author of study.

Medical Research: What are the main findings of the study?

Answer: It was found that patients with diabetes mellitus (DM) presenting with acute myocardial infarction (AMI) have a higher in-hospital mortality rate compared to patients without DM. Patients with insulin-requiring diabetes mellitus presenting with non-ST-segment elevation myocardial infarction had higher in-hospital mortality rate than patients with non-insulin requiring diabetes mellitus.

Medical Research: What was most surprising about the results?

Answer: We were surprised to find that despite the advancement in the interventional and medical techniques in the management of AMI, patients with diabetes mellitus continue to have worse in-hospital outcomes.

Medical Research: What should clinicians and patients take away from your report?

Answer: Patients with diabetes mellitus presenting with acute myocardial infarction are undertreated and tend to have worse in-hospital outcomes.

Care must be undertaken to ensure that this group of patients is receiving guideline-directed therapy and optimal clinical care.

Although not specifically studied in our report, a multidisciplinary approach with both cardiologists and endocrinologists (both on inpatient and outpatient basis) may be of benefit to patients with DM presenting with acute myocardial infarction.

Medical Research: What recommendations do you have for future research as a result of this study?

Answer: Additional research studies are needed to determine the influence of specific therapies for patients with diabetes mellitus presenting with AMI, specifically patients with insulin-requiring diabetes mellitus. In addition, although our study did not show any clinically significant difference in patients with newly diagnosed diabetes mellitus(Hemoglobin A1C > 6.5%) presenting with acute myocardial infarction, further in-depth studies are in need to look at this group of patients.

Citation:

Talla A. Rousan, Reji M. Pappy, Anita Y. Chen, Matthew T. Roe, Jorge F. Saucedo
American Journal of Cardiology, Vol. 114, Issue 8, p1136–1144
Published online: July 29, 2014