Abstract
Objectives: To evaluate the effects of diabetes mellitus (DM) on outcome and survival of patients with first
acute Myocardial Infarction (AMI).
Methods: In 500 patients (358 men and 142 women), 74 (12.6%) were diabetic, and rest of them were non–
diabetic. All diabetic patients were divided in to two groups, Group A included 13 patients with type 1 DM
and the group B included 61 patients with type 2 DM.
Results: Age–Adjusted mortality in one year follow-up for women with DM was 22%, and significantly
higher than 13% in women without DM, (relative risk (RR) 1.69 and 95% CI 1.21 to 2.06). Mortality rate for
men with DM (21%) and without DM (16%) was also significantly different (RR 1.31 and 95% CI 1.05-
1.62). Painless AMI occurred in15.4% of patients with type 1 and 14.4% of patients with type 2. One year
mortality rate in both type 1 and 2 were 19.6% and 21.3% respectively (p>0.05). According to angiographic
data, diabetic patients had more involved arteries than non diabetics (mean 2.62 vs. 2.07 vessels; P<0.05).
Left ventricular function study demonstrated 34.03% of diabetic patients had lower (<40%) ejection fraction
(EF), while 17.6% of nondiabetic patients had EF<40% (p<0.05).
Conclusion: Our results emphasis the role of DM as a risk factor of severity of coronary artery disease and
as a predictor of adverse outcome after first AMI. (Rawal Med J 2007;32:131-134).
Key words: Acute myocardial infarction, diabetes mellitus type 1 and type 2, painless AMI, Mortality rate
