Optimal medical therapy improves outcomes in patients with diabetes mellitus and acute myocardial infarction
Authors' conclusion
Guideline-recommended OMT was prescribed at suboptimal frequencies with geographic variations in this worldwide cohort. OMT can improve long-term clinical outcomes in patients with DM and AMI.
Study context
- Population
- Patients with AMI and diabetes mellitus (DM) in the BleeMACS registry of acute coronary syndrome, followed up for at least 1 year, 15 centres, 2003–201423.2% of registry
- Participants
- 3,095 patients
- Exposure
- Optimal medical therapy (OMT) at hospital discharge vs no OMT
- OMTn = 1,898
- Outcome
- Mortality
Methodological detailsBleeMACS, 15 centres, propensity score matching
- BleeMACS
- 15 centres
- Propensity score matching
Main finding
As reported in the abstract
- OMT vs No OMT: P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Re-AMIReduced with OMT (4.4% vs. 8.1%) | P < 0.001 |
| Composite of death/re-AMIReduced with OMT (8.0% vs. 17.6%) | P < 0.001 |
Regional differences
- No difference was observed among regions
Mortality after propensity score matching
- OMT significantly associated with lower mortality
- Propensity score matching
Independent factors of 1-year mortality (adjusted)
- Protective: OMT, drug-eluting stents, complete revascularization
- Risk factors: left ventricular ejection fraction and age
Original publication
Optimal medical therapy improves outcomes in patients with diabetes mellitus and acute myocardial infarction. Diabetes Res Clin Pract. Published 20 July 2023. doi:10.
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