Abstract 19423: Prevalence, Characteristics, Treatment and In-hospital Outcomes of Diabetes Mellitus in Patients with Acute Myocardial Infarction in China from the China Acute Myocardial Infarction Registry
Background: AMI has become a major cause of hospitalization and mortality in China over the last 3 decades. The prevalence of diabetes mellitus (DM) has also been dramatically increasing. But data on DM among patients with AMI in the Chinese population is lacking.
Methods: The China AMI registry is a representative, prospective, multicenter, national registry that includes 105 hospitals across three levels (provincial, prefecture and county) from 31 provinces and municipalities throughout Mainland China. We analyzed the characteristics, treatments and risk-adjusted in-hospital outcomes of DM in patients with AMI registered from Jan 2013 through Mar 2014.
Results: Among 15,547 patients with AMI, 20.5% have DM. Of note, though, among patients without known DM, 18.7% had HbA1C levels ≥6.5%, suggesting under appreciation of the diagnosis. Known DM was more prevalent in Northern than Southern China (22.3% vs. 17.6%, P<0.001) and among patients admitted to the larger, more urban hospitals (22.1% in provincial-level, 20.3% in prefecture-level and 17.2% in county-level hospitals). About 81.8% of the patients with known DM had HbA1C levels ≥6.5%, suggesting suboptimal glycemic control. Use of aspirin and statins prior to MI presentation was low (<20%). During the hospitalization, aspirin, P2Y12 receptor inhibitor and statin use was high (>90% for each). The in-hospital mortality rate in patients with AMI and DM was higher than that without DM (Adjusted OR=1.32, 95%CI: 1.05-1.68, P=0.02), with the highest mortality in county hospitals.
Conclusions: DM is prevalent in patients with AMI, with regional differences in China. A substantial number of patients with diabetes remained undiagnosed prior to MI and even those with the diagnosis appeared to be undertreated in terms of preventive therapy. Patients with DM had higher in-hospital mortality than those without DM. Further appreciation and treatment of DM in China and efforts to reduce in-hospital mortality of AMI are needed.
Author Disclosures: H. Xu: None. Y. Yang: Research Grant; Significant; Abbott. X. Tang: None. J. Yang: None. E.M. Antman: Research Grant; Significant; Daiichi Sankyo. S.D. Wiviott: Research Grant; Significant; AstraZeneca, Merck,Eisai. M.S. Sabatine: Research Grant; Significant; Abbott Laboratories; Amgen; AstraZeneca; AstraZeneca / Bristol-Myers Squibb Alliance; Critical Diagnostics; Daiichi-Sankyo; Eisai; Genzyme; GlaxoSmithKline; Intarcia; Merck; Roche Diagnostics; Sanofi-. Consultant/Advisory Board; Modest; Amgen; AstraZeneca; Bristol-Myers Squibb; Intarcia; MyoKardia; Pfizer; Sanofi-aventis; Zeus.
- © 2014 by American Heart Association, Inc.