Magnitude, treatment, and impact of diabetes mellitus in patients hospitalized with non-ST segment elevation myocardial infarction: A community-based study.
OBJECTIVE
To examine differences in the characteristics, treatment practices and in-hospital outcomes of patients with and without previously diagnosed diabetes hospitalized for non-ST segment elevation myocardial infarction.


METHODS
The study cohort consisted of 3916 patients diagnosed with non-ST segment elevation myocardial infarction at all 11 central MA medical centres between 1999 and 2009, of whom 1475 (38%) had been previously diagnosed with diabetes.


RESULTS
Diabetic patients were more likely to have received treatment with effective cardiac medications, and to have undergone coronary bypass surgery, but were less likely to have received a percutaneous coronary intervention, than non-diabetic patients. Patients with a history of diabetes were more likely to have developed cardiogenic shock, heart failure and died during their index hospitalization than non-diabetic patients.


CONCLUSIONS
Diabetic patients presenting with non-ST segment elevation myocardial infarction remain at high risk of developing significant clinical complications during hospitalization.
Department of Community Medicine/Department of Internal Medicine, Mercer University School of Medicine, Macon, GA, USA.
Hamza H
HH
Awad
Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
Mayra
M
Tisminetzky
Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA.
Diana
D
Metry
Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
David
D
McManus
Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
Jorge
J
Yarzebski
Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
Joel M
JM
Gore
Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA Robert.Goldberg@umassmed.edu.
Robert J
RJ
Goldberg
D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000453:epidemiology
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D004232:Diuretics; D000960:Hypolipidemic Agents
Diabetes mellitus; NSTEMI; outcomes research; population-based study