Long-term excess mortality associated with diabetes following acute myocardial infarction: a population-based cohort study

Alabas et al1 recently published a study in your journal on the long-term excess mortality associated with diabetes following acute myocardial infarction (AMI) after adjustment for comorbidity, risk factors and cardiovascular treatments. Diabetes was independently associated with a 56% higher mortality following STEMI and 39% following NSTEMI than in patients with AMI without diabetes. The study was based on the Myocardial Ischaemia National Audit Project (MINAP) and comprised more than 700 000 patients with AMI in England and Wales. The results underline the need to improve the treatment of diabetes itself in patients with AMI.

We have a serious problem with the low percentage of 17.1% of patients with diabetes in this study. In 2004 the Euro Heart Survey2 revealed that 31% of patients with coronary artery disease (CAD) had diabetes mellitus, 15% had newly detected diabetes and 19% had impaired glucose tolerance on OGTT. Normal...

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