Asessement of myocardial infarction therapy development in diabetics

Introduction A considerable development of myocardial infarction treatment including invasive strategy and supportive pharmacotherapy ought to result in prognostic benefits for the high risk diabetic population. Objectives The aim of the present study was the evaluation of myocardial infarction treatment efficacy in diabetics from Świętokrzyskie province. Patients and methods Two groups of diabetics hospitalized because myocardial infarction were compared: group 1 included 183 patients treated during the years 1992–1996, group 2 was comprised of 168 patients treated in the years 2005–2006. Results Population of diabetic patients treated in the years 2005–2006 was older and presented more coronary risk factors than patients hospitalized in the years 1992–1996. A significant more frequent use of myocardial infarction reperfusion treatment in diabetic patients was demonstrated. In 1992–1996, fibrinolytic therapy was used in 18% of diabetics, while currently the reperfusion strategy was performed in 47.2% of the study patients including fibrinolysis in 8.5% of patients, primary percutaneous coronary intervention in 38.7% of patients. In both study groups a comparably high mortality observed during the hospitalization and the 6‑month follow‑up incidence was observed. In the years 1992–1996 a significant decrease of mortality among diabetics who were treated by fibrinolytic methods compared to diabetics treated by conservative methods, was observed. In the years 2005–2006 in‑hospital and long‑term mortality were significantly reduced among diabetics who had undergone invasive therapy. Conclusions A significant development of myocardial infarction treatment in diabetics, particularly in those who underwent reperfusion methods, was demonstrated. The absence of reduction in overall mortality ought to be attributed to the worse clinical characteristics of recently treated patients and lower frequency of reperfusion treatment in high risk patients.