Abstract 2391: Trends In Early And 6-month Mortality Over 10 Years In Diabetic Vs Non Diabetic Patients With Acute Myocardial Infarction. Results From The USIK 1995, USIC 2000 And FAST-MI French Registries
Background: Several studies have documented marked improvement in the outcome of diabetic patients with AMI over the recent years.
Aim: To assess whether the evolution of mortality of AMI was different in diabetic and non diabetic patients.
Methods: USIK 1995, USIC 2000 and FAST-MI are 3 nationwide French registries conducted 5 years apart, using a similar methodology in consecutive patients admitted to CCUs over a one-month period. All 7504 patients presenting <48 hrs of symptom onset were included.
Results: The prevalence of known diabetes mellitus at admission increased from 1995 to 2000 and 2005 (17% v 21% v 24%, p<0.001). Diabetic patients were older than non diabetic patients (70 ± 12 v 66 ± 15 years, p<0.001). Overall, there was no change in age from 1995 to 2005 (67 ± 14 years for both periods), both in diabetic (70 ± 12 years) and non diabetic (66 ± 14 v 66 ± 15 years) patients. 30-day mortality: see Table⇓. In patients with STEMI, relative risk reduction was 47% in diabetic and 52% in non diabetic patients. In NSTEMI patients, the respective figures were 56% and 39%. Kaplan- Meier survival at 6-month in the overall population increased from 83% (1995) to 87% (2000) and 89% (2005) (p<0.001). Improvement was observed in diabetic (76% to 79% to 84%, p<0.001) as in non diabetic (85% to 89% to 91%, p<0.001) pts, and for both STEMI and NSTEMI. For STEMI, relative risk reduction from 1995 to 2005 was 37% in diabetic and 46% in non diabetic patients; for NSTEMI, the respective figures were 34% in diabetic and 25% in non diabetic patients.
Conclusion: Over the past 10 years, mortality of diabetic patients has considerably decreased. However, mortality of non diabetic patients has decreased in similar proportions, leaving a persistent gap between diabetic and non diabetic patients. Six-month survival of diabetic patients after AMI in 2005 is similar to 6-month survival of non diabetic patients 10 years earlier (84% vs 85%).