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KMID : 0338420210360000099
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The Korean Journal of Internal Medicine
2021 Volume.36 No. 0 p.99 ~ p.113
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Sex differences in long-term clinical outcomes of acute myocardial infarction according to the presence of diabetes mellitus
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Kim Yu-Ri
Jeong Myung-Ho
Ahn Young-Keun
Kim Ju-Han
Hong Young-Joon
Kim Min-Chul
Cho Kyung-Hoon
Han Xiong Yi
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Abstract
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Background/Aims: This study compared long-term clinical outcomes between male and female acute myocardial infarction (AMI) patients with and without diabetes mellitus (DM).
Methods: From November 2011 to December 2015, 13,104 patients with AMI were enrolled in the Korea Acute Myocardial Infarction Registry National Institutes of Health (KAMIR-NIH) (4,458 diabetic patients and 8,646 non-diabetic patients). Propensity score matching (PSM) was used to reduce bias due to confounding variables. Following PSM, 2,046 diabetic patients, 1,023 males (69.8 ± 9.4 years) and 1,023 females (69.9 ± 9.4 years); and 3,412 non-diabetic patients, 1,706 males (70.0 ± 10.4 years) and 1,706 females (70.4 ± 10.8 years) were analyzed. Clinical outcomes were compared between male and female patients with and without diabetes over a 3-year clinical follow-up.
Results: In diabetic patients, mortality (21.1% vs. 21.5%, p = 0.813) and major adverse cardiac events (MACE) (30.6% vs. 31.4%, p = 0.698) were not significantly different between males and females. However, mortality (15.8% vs. 12.0%, p = 0.002) and MACE (20.8% vs. 15.6%, p < 0.001) were significantly higher in male non-diabetic patients than in female non-diabetic patients. The predictors of mortality for both males and females in the diabetic and non-diabetic groups were old age, heart failure, renal dysfunction, anemia, and no percutaneous coronary intervention.
Conclusions: The long-term clinical outcomes in AMI patients with DM did not significantly differ by sex. However, the mortality and MACE in non-diabetic male patients were higher than those in females.
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KEYWORD
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Sex, Myocardial infarction, Diabetes mellitus, Prognosis
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