Authors

• Tomislav Čikara — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-8012-4481
• Ivan Skorić — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-5201-2092
• Miroslav Raguž — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0003-1567-8503
• Irzal Hadžibegović — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-3768-9134
• Šime Manola — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-6444-2674
• Ivana Jurin — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-2637-9691

Keywords

acute myocardial infarction, diabetes, major adverse cardiac events, metabolic syndrome

DOI

Full Text

**Introduction:** Diabetes mellitus (DM) is an important risk factor for acute myocardial infarction (AMI) and a frequent comorbidity in patients hospitalized with AMI (1). After the first AMI, a considerable proportion of patients are newly diagnosed with diabetes mellitus (DM) (2). We observed the number of patients with newly diagnosed DM (new-DM) among patients hospitalized with AIM and their characteristics and clinical course in comparison to patients with established diabetes (known-DM) and patients who did not have DM (non-DM). **Patients and Methods:** The study included 1743 patients with AMI admitted in Dubrava University Hospital between January 2017 and December 2021. We defined new-DM as (1) unknown history of DM at presentation (2) DM listed as a discharge diagnosis. We compared characteristics (age, sex, past medical history) and clinical course of patients with new-DM and those with know-DM and non-DM over 3 years period post-AMI (M(Q1-Q3) 1244 days (934-1565)). **Results:** Among 1743 patients there was 74 (4.24%) patients with new-DM, 420 (24.09%) patients with established diabetes (known-DM) and 1239 (71.08%) patients who didn’t had DM (non-DM). We also noticed a group of 10 patients (0.57%) who had criteria for DM (HbA1c ≥ 6.5%, FPG ≥ 7.0 mmol/L, RPG≥ 11.1 mmol/L) but did not had DM listed as discharge diagnosis. Compared to know-DM patients with new-DM where younger (M(Q1-Q3) 61(55-70) vs 69(61-77)) and had less comorbidities (hypertension, dyslipidemia, atrial fibrillation, prior stroke, peripheral artery disease). The incidence of all-cause death and major adverse cardiovascular events (MACE) was significantly higher in the known-DM group than in the non-DM and new-DM groups (HR (95% CI) = 1.95 (1.36-2.81), p < 0.001; HR (95% CI) = 1.66 (1.28-2.16), p < 0.001). However, in follow-up period new-DM group did not have significantly higher incidence of all-cause death and MACE as know-DM group. **Conclusion:** Newly diagnosed diabetes mellitus is frequent in patients hospitalized with for AMI and it is recommended that all patients with AMI be screened for DM. Unlike known-DM, new-DM was not associated with higher risks of major adverse cardiac events in follow-up period (2, 3).

Literature

1. Milazzo V, Cosentino N, Genovese S, Campodonico J, Mazza M, De Metrio M, et al. Diabetes Mellitus and Acute Myocardial Infarction: Impact on Short and Long-Term Mortality. Adv Exp Med Biol. 2021;1307:153–69. https://doi.org/10.1007/5584_2020_481
2. Park HW, Kang MG, Kim K, Koh JS, Park JR, Jeong YH, et al. KAMIR-NIH registry. Long-term Prognosis and Clinical Characteristics of Patients with Newly Diagnosed Diabetes Mellitus Detected after First Acute Myocardial Infarction: from KAMIR-NIH Registry. Korean Circ J. 2018 February;48(2):134–47. https://doi.org/10.4070/kcj.2017.0174
3. American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020 January;43 Suppl 1:S14–31. https://doi.org/10.2337/dc20-S002