THROMBOLYTIC THERAPY IN DIABETIC-PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION

OBJECTIVE - To compare the frequency of thrombolytic therapy in diabet ic and nondiabetic patients with acute myocardial infarction (MI) and to examine why some diabetic patients do not receive thrombolytic ther apy. RESEARCH DESIGN AND METHODS - Retrospective study of all diabetic patients with acute MI admitted to the coronary care unit of Aalborg Hospital within a 3-year period. RESULTS - Only 35% (43 of 123) of pat ients with diabetes compared with 47% (404 of 856) of patients without diabetes received thrombolytic therapy (P < 0.002). There was no diff erence in the percentage of patients thrombolyzed among patients admit ted to the hospital within 12 h after onset of symptoms. Of diabetic p atients who were not thrombolyzed, 60% (48 of 80) arrived at the hospi tal later than 12 h after onset of symptoms. Among patients who arrive d late, 63% (35 of 56) had Q wave infarction and 84% (47 of 56) had sy mptoms typical of acute MI. Mortality was 29% (16 of 56) in this group . Only one patient did not receive thrombolytic therapy due to diabeti c retinopathy. CONCLUSIONS - Significantly fewer diabetic patients rec eived thrombolytic therapy compared with patients without diabetes. Th e main reason diabetic patients did not receive thrombolytic therapy w as late arrival to the hospital.