Hellenic Journal of Cardiology ( IF 4.1 ) Pub Date : 2023-11-11 , DOI: 10.1016/j.hjc.2023.11.002 Kenichi Matsushita 1 , Sunao Kojima 2 , Kyoko Hirakawa 3 , Noriaki Tabata 3 , Miwa Ito 3 , Kenshi Yamanaga 3 , Koichiro Fujisue 3 , Tadashi Hoshiyama 3 , Shinsuke Hanatani 3 , Daisuke Sueta 3 , Hisanori Kanazawa 3 , Seiji Takashio 3 , Yuichiro Arima 3 , Satoshi Araki 3 , Hiroki Usuku 3 , Satoru Suzuki 3 , Eiichiro Yamamoto 3 , Taishi Nakamura 3 , Hirofumi Soejima 3 , Koichi Kaikita 4 , Kenichi Tsujita 3
Background
Patients with acute myocardial infarction (AMI) complicating renal dysfunction (RD) are recognized as being at high risk. Although diabetes mellitus (DM) is a major cause of RD, the prognostic impact of coexisting DM on mortality in patients with AMI complicating RD is ill-defined. This study compared the prognostic impact of coexisting DM in patients with AMI complicating RD according to both age and sex.
Methods
A multicenter retrospective study was conducted on 2988 consecutive patients with AMI complicating RD (estimated glomerular filtration rate < 60 mL/min per 1.73 m2). Multivariable Cox regression analysis was performed to investigate the effects of DM on in-hospital mortality.
Results
Statistically significant interactions between age and DM and between sex and DM for in-hospital mortality were revealed in the entire cohort. Coexisting DM was identified as an independent risk factor for in-hospital mortality (hazard ratio [HR], 2.543) in young (aged < 65 years), but not old (aged ≥ 65 years), patients. DM was identified as an independent risk factor (HR, 1.469) in male, but not female, patients. Kaplan-Meier survival curves showed that DM correlated with significantly low survival rates in patients that were young or male as compared to those who were old or female.
Conclusions
There were significant differences in the prognostic impact of DM on in-hospital mortality between young and old as well as male and female patients with AMI complicating RD. These results have implications for future research and the management of patients with DM, RD, and AMI comorbidities.