title: Management and in-hospital outcome of patients with first episode of acute myocardial infarction: impact of diabetes mellitus.
abstract: The aim of this study is to compare clinical characteristics, management, complications, in-hospital outcome and mortality of diabetic and nondiabetic patients after the first episode of acute myocardial infarction (MI). This retrospective case-matched study included 60 diabetic and 55 non-diabetic patients. Medical information about patients was retrieved from the hospital recordings. Diabetic patients were older, were more hypertensive and had more coronary artery disease history than nondiabetic patients. The frequency of use of acute reperfusion therapy modalities was not statistically different between the two groups. Diabetes was a significant determinant against the use of beta blockers (OR=0.26; 95% CI 0.06-0.95) but in favor of angiotensin converting enzyme inhibitors (OR=3.3; 95% CI 1.17-9.36), whereas diabetes did not influence the use of other drugs. Diabetic patients had more complications than nondiabetic patients (40.0% and 16.3%, respectively, p=0.005). In-hospital mortality rate for diabetic patients was comparable to nondiabetic patients (16.7% and 10.9%, respectively, p=0.373). Pharmaceutical treatment regimens, particularly beta blockers, are underutilized after acute MI in diabetic patients. More frequent use of these regimens will improve the high complication and mortality rates in diabetic patients as well as in nondiabetic patients.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey. aysegulakin@yahoo.com
authors.forename: Aysegul
authors.initials: A
authors.lastname: Atmaca
authors.forename: Serkan
authors.initials: S
authors.lastname: Dogan
authors.forename: Selcuk
authors.initials: S
authors.lastname: Dagdelen
authors.forename: Giray
authors.initials: G
authors.lastname: Kabakci
authors.forename: Sirri
authors.initials: S
authors.lastname: Kes
authors.forename: Nasih
authors.initials: N
authors.lastname: Nazli
authors.forename: Tomris
authors.initials: T
authors.lastname: Erbas
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D016022:Case-Control Studies; D003925:Diabetic Angiopathies / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors