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Chiang CH, Huang WC, Yang JS, et al. Five-Year Outcomes after Acute Myocardial Infarction in Patients with and without Diabetes Mellitus in Taiwan, 1996-2005. Acta Cardiol Sin. 2013;29(5):387-94
Chiang, C. H., Huang, W. C., Yang, J. S., Cheng, C. C., Kuo, F. Y., Chiou, K. R., Lee, T. Y., Lin, T. W., Mar, G. Y., Chiou, C. W., Liu, C. P., & Lee, K. T. (2013). Five-Year Outcomes after Acute Myocardial Infarction in Patients with and without Diabetes Mellitus in Taiwan, 1996-2005. Acta Cardiologica Sinica, 29(5), 387-94.
Chiang, Cheng-Hung, et al. "Five-Year Outcomes after Acute Myocardial Infarction in Patients with and without Diabetes Mellitus in Taiwan, 1996-2005." Acta Cardiologica Sinica vol. 29,5 (2013): 387-94.
Chiang CH, Huang WC, Yang JS, Cheng CC, Kuo FY, Chiou KR, Lee TY, Lin TW, Mar GY, Chiou CW, Liu CP, Lee KT. Five-Year Outcomes after Acute Myocardial Infarction in Patients with and without Diabetes Mellitus in Taiwan, 1996-2005. Acta Cardiol Sin. 2013 Sep;29(5):387-94. PMID: 27122735; PMCID: PMC4804787.
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Acta Cardiol Sin. 2013 Sep;29(5):387-94.

Five-Year Outcomes after Acute Myocardial Infarction in Patients with and without Diabetes Mellitus in Taiwan, 1996-2005.

Acta Cardiologica Sinica

Cheng-Hung Chiang, Wei-Chun Huang, Jin-Shiou Yang, Chin-Chang Cheng, Feng-Yu Kuo, Kuan-Rau Chiou, Tao-Yu Lee, Tzu-Wen Lin, Guang-Yuan Mar, Chuen-Wang Chiou, Chun-Peng Liu, King-Teh Lee

Affiliations

  1. Cardiovascular Medical Center, Kaohsiung Veterans General Hospital; ; Graduate Institute of Healthcare Administration, Kaohsiung Medical University, Kaohsiung;
  2. Cardiovascular Medical Center, Kaohsiung Veterans General Hospital; ; School of Medicine, National Yang-Ming University, Taipei; ; Department of Physical Therapy, Fooyin University;
  3. Department of Physical Therapy, Fooyin University;
  4. Cardiovascular Medical Center, Kaohsiung Veterans General Hospital; ; School of Medicine, National Yang-Ming University, Taipei;
  5. Cardiovascular Medical Center, Kaohsiung Veterans General Hospital;
  6. Cheng Shiu University;
  7. Graduate Institute of Healthcare Administration, Kaohsiung Medical University, Kaohsiung; ; Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

PMID: 27122735 PMCID: PMC4804787

Abstract

BACKGROUND: Diabetes mellitus (DM) is a strong risk factor of cardiovascular disease. To date, the impact of DM on outcomes after acute myocardial infarction (AMI) in Taiwan is undetermined. The aim of this study was to compare five-year outcomes after AMI in patients with and without diabetes in Taiwan.

METHODS: A nationwide cohort of 25,028 diabetic and 56,028 non-diabetic patients who were first hospitalized with AMI between 1996 and 2005 was enrolled through linkage with the Taiwan National Health Insurance research database. Patient mortality rates within 30 days after AMI, and 1, 3, and 5 years thereafter were compared.

RESULTS: Length of hospital stay (8.9 ± 8.7 vs. 8.2 ± 8.0 days, p < 0.01) and medical cost during admission (in Taiwan dollars: $129,123 ± $158,073 vs. $121,631 ± $157,018, p < 0.01) were significantly higher in diabetic patients. The difference in mortality rate within 30 days was insignificant between diabetic and non-diabetic patients (18.1% vs. 17.6%, p = 0.06). Mortalities within 1 year (31.0% vs. 26.8%, p < 0.01), 3 years (42.4% vs. 34.7%, p < 0.01), and 5 years (50.6% vs. 41.1%, p < 0.01) were significantly higher in diabetic patients. In patients with AMI who underwent percutaneous coronary intervention (PCI) during index admission, the mortality rate within 30 days was insignificant (6.3% vs. 6.4%, p = 0.70) but mortalities within 1 year (15.2% vs. 11.6%, p < 0.01), 3 years (24.1% vs. 17.2%, p < 0.01), and 5 years (32.2% vs. 22.6%, p < 0.01) were significantly higher in diabetic patients.

CONCLUSIONS: The average patient length of hospital stay and medical cost during admission were significantly higher in diabetic patients. Additionally, the difference in mortality rate within 30 days after AMI was insignificant between diabetic and non-diabetic patients. Also, long-term mortality after AMI was significantly higher in diabetic patients.

KEY WORDS: Acute myocardial infarction; Diabetes mellitus; Length of hospital stay; Medical cost; Mortality; National health insurance.

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