Centro Cardiologico Monzino IRCCS, Milan, Italy.
Adv Exp Med Biol. 2021;1307:153-169. doi: 10.1007/5584_2020_481.
Diabetes mellitus (DM) is an important risk factor for acute myocardial infarction (AMI) and a frequent co-morbidity in patients hospitalized with AMI, being present in about 30% of cases. Although current treatment of AMI has considerably improved survival in both patients with and without DM, the presence of DM still doubles the case fatality rate during both the acute phase of AMI and at long-term follow-up. This higher mortality risk of DM patients strongly indicates a particular need for better treatment options in these patients and suggests that intensive medical treatment, prolonged surveillance, and stringent control of other risk factors should be carefully pursued and maintained for as long as possible in them.In this review, we will focus on the close association between DM and in-hospital and long-term mortality in AMI patients. We will also aim at providing current evidence on the mechanisms underlying this association and on emerging therapeutic strategies, which may reduce the traditional mortality gap that still differentiates AMI patients with DM from those without.
糖尿病(DM)是急性心肌梗死(AMI)的重要危险因素,也是AMI 住院患者的常见合并症,约占 30%。尽管目前 AMI 的治疗方法极大地提高了有或无 DM 患者的生存率,但 DM 的存在仍使 AMI 急性期和长期随访期间的病死率增加了一倍。DM 患者的这种更高死亡风险强烈表明,这些患者特别需要更好的治疗选择,并表明应在尽可能长的时间内仔细追求和维持对这些患者的强化医疗、长期监测和严格控制其他危险因素。在本次综述中,我们将重点关注 DM 与 AMI 患者住院期间和长期死亡率之间的密切关联。我们还将旨在提供关于这种关联背后机制的当前证据,以及新兴的治疗策略,这些策略可能会缩小仍然使 DM 患者与非 DM 患者区分开来的传统死亡率差距。