The impact of socio‐economic deprivation on the long‐term survival of people with diabetes and acute myocardial infarction: A nationwide cohort study
Authors' conclusion
Patients with DM from socio-economically deprived regions have a higher risk of mortality at 1 year, 5 years and overall, compared to least deprived patients with DM following AMI. However, the inequality gap was larger in the non-diabetic population, suggesting that current approaches to management in people with DM may mitigate some of the effect of deprivation on outcomes.
Study context
- Population
- Patients with acute myocardial infarction (AMI) in England and Wales, 2005–2019, Myocardial Ischaemia National Audit Project (MINAP) registry, followed up to 31 July 2021; with and without diabetes mellitus (DM)152,867 with DM
- Participants
- 729,722 patients
- Exposure
- Most deprived vs least deprived Index of Multiple Deprivation (IMD) quintile, by DM status
- Outcome
- Mortality, patients with DM (Q1 vs Q5)
Methodological detailsregistry-based (MINAP with Office for National Statistics (ONS) mortality recording), Cox regression, adjusted
- Registry-based (MINAP with ONS mortality recording)
- Cox regression, adjusted
Main finding
As reported in the abstract
Q1 vs Q5Adjusted hazard ratio (CI)P value
1-year mortality, DM
1.05(1.01–1.10)
P < 0.0015-year mortality, DM
1.14(1.11–1.17)
P < 0.001Overall mortality, DM
1.14(1.12–1.17)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | aHR (CI) | P value | |
|---|---|---|---|
| Mortality, patients without DM (Q1 vs Q5)Q1vs Q530-day mortality, non-DM | 1.05 (1.01–1.09) | P < 0.001 | |
| Mortality, patients without DM (Q1 vs Q5)Q1vs Q51-year mortality, non-DM | 1.12 (1.09–1.14) | P < 0.001 | |
| Mortality, patients without DM (Q1 vs Q5)Q1vs Q55-year mortality, non-DM | 1.18 (1.16–1.20) | P < 0.001 | |
| Mortality, patients without DM (Q1 vs Q5)Q1vs Q5Overall mortality, non-DM | 1.22 (1.20–1.23) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
Adjusted 1-year mortality, DM vs non-DM
- Q1: DM vs non-DM
- 18.8% vs. 16.1%
- Q5: DM vs non-DM
- 17.8% vs. 14.6%
- Higher in DM than non-DM regardless of IMD quintile
Original publication
The impact of socio‐economic deprivation on the long‐term survival of people with diabetes and acute myocardial infarction: A nationwide cohort study. Diabet Med. Published 28 July 2025. doi:10.
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