The effect of diabetes on survival after myocardial infarction (MI) was examined in a prospective population-based study of individuals hospitalized with MI in a bi-ethnic community of Mexican-Americans and non-Hispanic whites. Among Mexican-Americans, 54% (331 of 610) had diabetes compared with 33% (192 of 589) of non-Hispanic whites (P < 0.001). Among those with diabetes, the prevalence of a history of a cardiac event before the index admission was significantly higher (odds ratio = 1.4, 95% confidence interval [CI] 1.1–1.8) than among nondiabetic subjects. During the index hospitalization, diabetic subjects received cardiac catheterization less frequently than did nondiabetic subjects (45.1 vs. 51.5%, P = 0.03). Diabetic subjects had lower estimated ejection fractions, and the number of coronary arteries with significant obstruction (> 75%) was higher (P < 0.001). The peak creatine phosphokinase and creatine phosphokinase myocardial isoenzyme (CK-MB) levels were similar in diabetic and nondiabetic subjects. Despite a similar infarct size, diabetic subjects had a higher incidence of congestive heart failure (relative ratio = 2.2, 95% CI 1.7–2.8), more adverse indexes of short-term and long-term prognosis, and a longer average hospital stay (12.1 vs. 8.9 days, P < 0.01). After adjustment for age, sex, and ethnicity, the cumulative risk for total mortality, over 44 months of follow-up, was 37.4% among diabetic compared with 23.3% among nondiabetic subjects (P < 0.001). Diabetic subjects had a higher 28-day case-fatality rate post-MI as well as higher long-term mortality. In conclusion, diabetic subjects have similar size infarcts compared with nondiabetic subjects, but they have a more complicated hospital course and higher total mortality post-MI. Diabetes had a similar adverse effect on post-MI mortality in both Mexican-Americans and non-Hispanic whites.
The Relation of Diabetes to the Severity of Acute Myocardial Infarction and Post-Myocardial Infarction Survival in Mexican-Americans and Non-Hispanic Whites: The Corpus Christi Heart Project
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Philip R Orlander, David C Goff, Marilyn Morrissey, David J Ramsey, Mary L Wear, Darwin R Labarthe, Milton Z Nichaman; The Relation of Diabetes to the Severity of Acute Myocardial Infarction and Post-Myocardial Infarction Survival in Mexican-Americans and Non-Hispanic Whites: The Corpus Christi Heart Project. Diabetes 1 July 1994; 43 (7): 897–902. https://doi.org/10.2337/diab.43.7.897
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