Equal hospital but impaired 1-year outcome of MI in diabetics versus non-diabetics in the era of stringent reperfusion therapy - results of the OPTAMI registry

Abstract

Background: Type 2 diabetes (DM) is known to be a risk factor for the development of coronary heart disease and a prognostic factor in myocardial infarction. Little is known about its impact on hospital and long-term outcome in the era of stringent reperfusion therapy of STEMI and NSTEMI. Methods: The OPTAMI registry (Optimized Therapy of Acute MI) enrolled consecutive patients with STEMI or NSTEMI in 33 centres (27 with cathlab) in Germany to document patient characteristics, acute therapy, hospital and 1-year outcome. We examined the impact of DM on outcome of STEMI and NSTEMI in the era of primary / early PCI. Results: A total of 3180 patients were enrolled into OPTAMI. The prevalence of DM was 23.4% in STEMI and 34.5% in NSTEMI. Patients with DM were older, more often female and had a significantly higher prevalence of comorbidities. The overall acute reperfusion rate was high, however diabetics were less likely to undergo reperfusion therapy in both STEMI and NSTEMI. No differences were found for hospital mortality between patients with or without DM in both STEMI and NSTEMI. However, 1-year-mortality was significantly higher in diabetics as compared to non-diabetics for both STEMI and NSTEMI Conclusion: No difference was found in hospital mortality between diabetics and non-diabetics in the era of stringent reperfusion therapy. However, diabetics had significantly higher long-term mortality probably indicating the need for better secondary prevention treatment in this high risk population. (Table Presented).