title: Newly diagnosed and previously known diabetes mellitus and short-term outcomes in patients with acute myocardial infarction.
abstract: OBJECTIVE
  The prognostic value of diabetes mellitus (DM) on the long-term outcomes of patients after myocardial infarction has been well established. The correlation between DM, including newly diagnosed DM, and short-term outcomes needs to be validated.
  
  
  METHODS
  A total of 5410 ST-segment elevation myocardial infarction (STEMI) patients with typical chest pain onset in the past 12 h were enrolled. Follow-ups were carried out on days 7 and 30 after hospital admission. According to 2013 Standards of Medical Care in Diabetes, the study population was stratified into the following three groups: no diabetes, newly diagnosed diabetes, and previously known diabetes. The primary outcomes of our study were mortality from all causes and major adverse cardiac events (MACE) at days 7 and 30.
  
  
  RESULTS
  Patients with previously known diabetes were older and had a higher incidence of previous history of cardiovascular disease compared with the other groups. The 7-day and 30-day mortality was similar between patients without DM and patients with newly diagnosed DM. For both groups, this was significantly lower than that in patients with DM. Similar results were observed for 7-day and 30-day MACE. Multivariable Cox regression analysis indicated that newly diagnosed diabetes did not correlate with 30-day MACE (hazard ratio, 0.901; 95% confidence interval, 0.759-1.069), but that previously known DM correlated with short-term MACE (hazard ratio, 1.211; 95% confidence interval, 1.009-1.453).
  
  
  CONCLUSIONS
  Previously known DM, but not newly diagnosed DM, was an independent predictor for short-term MACE in patients with STEMI. To reduce the incidence of short-term MACE and the detrimental effects of stress hyperglycemia after STEMI, intensive insulin therapy should be provided to diabetic patients with STEMI.
authors.affiliation: aState Key Laboratory of Cardiovascular Disease, Emergency and Critical Care Centre of Cardiovascular Department, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing bDepartment of Endocrinology, Daqing People's Hospital, Daqing, Heilongjiang Province, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Tian
authors.forename: Chang
authors.initials: C
authors.lastname: Wei
authors.forename: Jun
authors.initials: J
authors.lastname: Zhu
authors.forename: Lisheng
authors.initials: L
authors.lastname: Liu
authors.forename: Yan
authors.initials: Y
authors.lastname: Liang
authors.forename: Jiandong
authors.initials: J
authors.lastname: Li
authors.forename: Yanmin
authors.initials: Y
authors.lastname: Yang
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin