Diabetes mellitus as a contributor to the in-hospital mortality after acute myocardial infarction in Kuwait.
OBJECTIVE
First, to compare the in-hospital mortality after acute myocardial infarction (AMI) among diabetic versus non-diabetic patients. Secondly, to evaluate if this association remains the same across gender and ethnic groups.


RESULTS
We used a 1:2 individually matched retrospective case-control study. All patients admitted to Mubarak Al-Kabeer hospital in Kuwait, with a confirmed diagnosis of AMI during August 1997 and July 2002 made up the study population. All 149 patients who died during this period made up the cases. Two control subjects to match each case were randomly chosen from survivors, after hospitalization with AMI. Cases and controls were individually matched by age, sex and ethnicity. History of diabetes mellitus (DM) was found to be significantly associated with in-hospital mortality after AMI (odds ratio: 1.9, 95% CI: 1.2-3.0). None of the other cardiovascular related histories were associated with mortality. Further analyses on the type of diabetes showed that the NIDDM (non-insulin dependent diabetes mellitus) risk of mortality was significantly raised after AMI. Also among women (odds ratio: 2.7, 95% CI: 1.2-5.9), and non-Kuwaiti population (odds ratio: 3.4, 95% CI: 1.1-9.9) the risk was significantly elevated.


CONCLUSIONS
Risk of in-hospital mortality after AMI is almost doubled among diabetic patients. This association was found to be significantly higher among NIDDM, women and non-Kuwaiti population.
Thalib
Lukman
L
Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, Safat, Kuwait. lthalib@hsc.kuniv.edu.kw
Zubaid
Mohammad
M
Suresh
Cheriyil G
CG
Rashed
Wafa
W
Shukkur
Mumtaz
M
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003325:Coronary Care Units / Q000706:statistics & numerical data*; D048909:Diabetes Complications; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007730:Kuwait / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality*; D012189:Retrospective Studies