Prognosis following first acute myocardial infarction in Type 2 diabetes: a comparative population study

Aims To estimate the incidence of death and macrovascular complications after a first myocardial infarction for patients with Type 2 diabetes. Research design In a retrospective, incidence cohort study in the Tayside Region of Scotland we studied all patients hospitalized with a diagnosis of first acute myocardial infarction from 1 April 1993 to 31 December 1994. The primary endpoint was time to death. Secondary endpoints were 2‐year incidence of hospital admission for angina, myocardial infarction, stroke, heart failure, coronary angiography, coronary artery bypass graft (CABG) and percutaneous transluminal coronary angioplasty (PTCA). Results The 147 patients with Type 2 diabetes had significantly worse survival with an increase in relative hazard of 67% compared with non‐diabetic patients. After adjustment for age, sex, smoking status, prior heart failure, prior angina, delay to hospitalization, site of infarction, drug therapy with aspirin, β‐blockers, streptokinase and hyperlipidaemia and treated hypertension, Type 2 diabetes was still associated with a 40% higher death rate compared with people without diabetes (P