Introduction. Due to the lifelong nature of diabetes mellitus (DM), it has been demonstrated
to have significant effects on patients’ morbidity and mortality. The present study
aimed to assess the effects of DM on the clinical outcome and survival in patients
who underwent percutaneous coronary intervention (PCI) due to myocardial infarction
(MI) and to examine the relationship of DM to the type of the MI and to left ventricular
(LV) and renal functions. Methods. A total of 12,270 patients with ST-elevation MI
(STEMI) or non-ST-elevation MI (NSTEMI) were revascularized at our Institution between
2005 and 2013. In this pool of patients, 4388 subjects had DM, while 7018 cases had
no DM. Results. In both STEMI and NSTEMI, the 30-day and 1-year survival were worse
in diabetic patients as compared to non-diabetic cases. In the patients with DM, NSTEMI
showed worse prognosis within 1-year than STEMI similarly to non-diabetic subjects.
Regarding survival, the presence of DM seemed to be more important than the type of
MI. Regardless of the presence of DM, reduced LV function was a maleficent prognostic
sign and DM significantly reduced the prognosis both in case of reduced and normal
LV function. Survival is primarily affected by LV function, rather than DM. Worse
renal function is associated with worse 30-day and 1-year survival in both cases with
and without DM. Considering different renal functions, the presence of DM worsens
both short- and long-term survival. Survival is primarily affected by renal function,
rather than DM. Conclusions. The results from a high-volume PCI center confirm significant
the negative prognostic impact of DM on survival in MI patients. DM is a more important
prognostic factor than the type of the MI. However, survival is primarily affected
by LV and renal functions, rather than DM. These results could highlight our attention
on the importance of recent DM treatment with new drugs including SGLT-2 inhibitors
and GLP-1 antagonists with beneficial effects on survival.
