The association between vascular disease and outcomes of patients with acute myocardial
infarction (AMI) has not been well-defined in the diabetes mellitus (DM) population.
All patients with DM presenting with AMI between October 2015 and December 2018 in
the National Inpatient Sample database were stratified by number and site of extracardiac
vascular comorbidity (cerebrovascular [CVD], renovascular, neural, retinal and peripheral
[PAD] diseases). Multivariable logistic regression was used to determine the adjusted
odds ratios (aORs) of in-hospital adverse outcomes and procedures. Of 1,116,670 patients
with DM who were hospitalized for AMI, 366,165 had ≥1 extracardiac vascular comorbidity
(32.8%). Patients with vascular disease had an increased aOR for mortality (aOR 1.05,
95% confidence interval [CI] 1.04 to 1.07), major adverse cardiovascular and cerebrovascular
events (MACCEs) (aOR 1.19, 95% CI 1.18 to 1.21), stroke (aOR 1.72, 95% CI 1.68 to
1.76), and major bleeding (aOR 1.11, 95% CI 1.09 to 1.13) and had lower odds of receiving
coronary angiography (CA) (aOR 0.90, 95% CI 0.90 to 0.91) and percutaneous coronary
intervention (PCI) (aOR 0.82, 95% CI 0.82 to 0.83) than patients without extracardiac
vascular disease. Patients with PAD had the highest odds of mortality (aOR 1.29, 95%
CI 1.27 to 1.32), whereas patients with CVD had the greatest odds of MACCEs, stroke,
and major bleeding (aOR 1.82, 95% CI 1.78 to 1.87, aOR 4.25, 95% CI 4.10 to 4.40,
and aOR 1.51, 95% CI 1.45 to 1.57, respectively). Patients with DM presenting with
AMI and concomitant extracardiac vascular disease were more likely to develop clinical
outcomes and less likely to undergo CA or PCI. Patients with PAD had the highest risk
of mortality, whereas patients with CVD had the greatest risk of MACCEs, stroke, and
major bleeding.
Graphical Abstract
Graphical Abstract
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Article Info
Publication History
Published online: May 09, 2022
Received in revised form:
March 29,
2022
Received:
January 19,
2022
Footnotes
Funding: None.
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