title: The Munich Myocardial Infarction Registry: impact of C-reactive protein and kidney function on hospital mortality in diabetic patients.
abstract: BACKGROUND
  The aim of this study was to analyse hospital mortality with regards to the presence of diabetes, elevation of C-reactive protein (CRP) levels and impaired kidney function (IKF) on admission.
  
  
  METHODS
  All patients in the Munich Myocardial Infarction Registry (1999-2004, n = 2,015) were assessed. In both the diabetic (n = 770, 38%) and non-diabetic (n = 1,245, 61.2%) groups, CRP and kidney function on admission were analysed with regards to hospital outcome.
  
  
  RESULTS
  In diabetic patients, both a CRP level >7 mg/L and a glomerular filtration rate (GFR) < 60 ml/min were independent risk factors for mortality (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.8-6.9 and OR 4.4, 95% CI 2.4-8.3, respectively). In non-diabetic patients with CRP levels equal or below the median and absence of IKF, hospital mortality was 0.7% whereas the presence of the triad of diabetes, CRP levels above the median and IKF increased hospital mortality to 23.5%.
  
  
  CONCLUSIONS
  The registry demonstrates that the presence of the triad of diabetes, elevated CRP levels and reduced GFR on admission is associated with an excessive hospital mortality. Optimised early interventions are to be initiated to potentially overcome the unfavourable prognosis.
authors.affiliation: Diabetes Research Institute, Helmholtz Center, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany. oliver.schnell@sciarc.de
authors.forename: Oliver
authors.initials: O
authors.lastname: Schnell
authors.forename: Karl Friedrich
authors.initials: KF
authors.lastname: Braun
authors.forename: Martin
authors.initials: M
authors.lastname: Müller
authors.forename: Eberhard
authors.initials: E
authors.lastname: Standl
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Otter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D005858:Germany / Q000453:epidemiology; D005919:Glomerular Filtration Rate; D017052:Hospital Mortality; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D016017:Odds Ratio; D010343:Patient Admission; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein