Long-term follow-up of diabetic patients with non-ST-segment elevation myocardial infarction.

objectiveNon-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.

methodsAll 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.

resultsA 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.

conclusionsMultiple 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.