Objective: Non-ST-segment elevation myocardial infarction (NSTEMI) is prevalent in patients with diabetes mellitus (DM). The long-term follow-up outcomes of this group of patients remain misunderstood. This study was aimed at investigating long-term follow-up outcomes of diabetic patients discharged with NSTEMI.
Methods: All diabetic patients discharged with MI were recruited and followed up in this study. Patients who had elevated serum troponin, but no ST segment elevation were considered as NSTEMI. A structured follow-up was conducted at 3 months, 6 months, 12 months, and 24 months. Independent risk factors for all-cause and cardiovascular mortality were analyzed.
Results: A total of 743 diabetic patients with MI enrolled for analysis, with 132 patients being recognized as NSTEMI. The mean age was 70.4±8.3 years. The mean follow-up was 21.3±6.1 months. NSTEMI (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.08-2.23), age ≥75 years (HR 1.17, 95% CI 1.04-1.31), hypertension (HR 1.51, 95% CI 1.03-2.21), heart failure (HF) (HR 3.23, 95% CI 2.28-4.57), and previous MI (HR 2.01, 95% CI 1.44-2.79) were independent risk factors for all-cause mortality. Administration of beta-blocker (HR 0.62, 95% CI 0.45-0.85) was associated with a lower incidence of all-cause mortality. Predictors for cardiovascular mortality included elderly, hypertension, HF, previous MI, and MI with atypical chest pain.
Conclusions: Multiple risk factors contribute to a higher incidence of composite outcomes in diabetic patients with MI. STEMI poses a greater threat to adverse events, which warrants more investigations.
Keywords: Diabetes mellitus; mortality; myocardial infarction; non-ST-segment elevation.
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