Myocardial Infarction Site and Mortality in Diabetes

Survival after a first myocardial infarction (MI) was examined in 54 diabetic and 270 nondiabetic subjects according to anatomic site of MI. Complete survival status information was obtained during a 12-yr follow-up. Compared with nondiabetic subjects, diabetics had a higher proportion of anterior site of MI below the age of 60 in both sexes. A significantly higher mortality was experienced in both sexes by patients with anterior MIs compared with other infarction sites (47% vs. 13% respectively, over 12 yr of follow-up). This excess fatality was differentially distributed by diabetic status. The 60-day mortality following admission with an anterior MI was significantly higher in diabetic (55%) than in nondiabetic subjects (31%). No differences in 60-day survival were found between diabetic and nondiabetic subjects with other infarction sites. Thus, anterior size and diabetic status each convey an increased risk of early postinfarct mortality. The findings from this study suggest that the presence of both is synergistic with regard to the 60-day mortality rate.