A SURVEY OF DRUG-TREATMENT AND OUTCOMES IN DIABETIC-PATIENTS WITH ACUTE MYOCARDIAL INFARCTS

Sixty-four diabetic patients suffering an acute myocardial infarct wer e retrospectively matched, by age, gender and smoking habit, to non-di abetic controls. The two groups were compared for cardiovascular risk factors, pre-admission and discharge drug treatment, in-hospital drug treatment, and complication and mortality rates. Hypertension was more prevalent in the diabetic (63%) than in the control (42%) group. When comparing drugs on admission to those at discharge, there was a signi ficant increase in antiplatelet and nitrate usage in both groups (P<0. 001), in beta-blocker usage in the control group (P<0.001) and in loop diuretic usage in the diabetic group (P<0.001). The usage of angioten sin converting enzyme inhibitors was low: 16% of diabetic patients and 5% of controls at discharge. Thrombolytic therapy was used in 29 diab etics and 37 controls. There was a significantly higher complication r ate in the diabetic group than in the control group (P<0.006), the mos t common being congestive cardiac failure (59% vs 30%, P<0.001). Four controls and 13 diabetic patients died; three of the latter had their diabetes diagnosed during the admission. This study did not clearly de monstrate any underlying risk factors or treatment variables to accoun t for the increased morbidity or mortality in diabetic patients with a cute myocardial infarct, when compared to a matched non-diabetic popul ation. However, modest associations not detected by this relatively sm all study are still possible.