Table 1.
Baseline characteristics of young patients with AMI, stratified by diabetes status
| Baseline characteristics | Without diabetes (n=2008, 57.4%) (a) |
P value* (b) vs (a) |
Newly diagnosed diabetes (n=508,14.5%) (b) | P value† (b) vs (c) |
Established diabetes (n=985,28.1%) (c) |
| Sociodemographics | |||||
| Age in year (SD) | 46.5 (6.4) | 0.002 | 47.5 (5.9) | 0.555 | 47.7 (5.8) |
| Female (%) | 1270 (63.3%) | 0.954 | 322 (63.4%) | 0.001 | 757 (76.9%) |
| Race | 0.001 | 0.188 | |||
| White | 1649 (82.1%) | 381 (75.0%) | 712 (72.3%) | ||
| Black | 248 (12.4%) | 90 (17.7%) | 212 (21.5%) | ||
| Others | 111 (5.5%) | 37 (7.3%) | 61 (6.2%) | ||
| Education status | 0.002 | 0.057 | |||
| Less than high school | 131 (6.7%) | 13 (2.6%) | 41 (4.2%) | ||
| Some high school | 784 (39.9%) | 202 (40.3%) | 431 (44.4%) | ||
| More than high school | 1048 (53.4%) | 286 (57.1%) | 498 (51.3%) | ||
| Cardiometabolic characteristics | |||||
| Body mass index >30 kg/m2 | 767 (38.3%) | 0.001 | 275 (54.2%) | 0.001 | 667 (67.9%) |
| Peak glucose, median (IQR) | 127.0 (38.0) | 0.001 | 141.0 (48.0) | 0.001 | 261.0 (162.0) |
| Initial systolic blood pressure (mm Hg), median (IQR) | 140.0 (37.0) | 0.034 | 143.0 (38.0) | 0.241 | 144.0 (42.0) |
| Initial diastolic blood pressure (mm Hg), median (IQR) | 87.0 (24.0) | 0.124 | 88.0 (27.0) | 0.020 | 86.0 (26.0) |
| LDL (mmol/L), median (IQR) | 111.0 (51.0) | 0.729 | 112.0 (56.0) | 0.008 | 106.0 (54.0) |
| TG (mmol/L), median (IQR) | 121.5 (95.0) | 0.001 | 137.0 (105.5) | 0.001 | 164.0 (154.0) |
| CVD risk factors | |||||
| Family history of CVD | 1395 (69.5%) | 0.034 | 382 (75.0%) | 0.884 | 728 (74.1%) |
| History of hypertension | 1096 (54.6%) | 0.069 | 300 (59.1%) | 0.001 | 821 (83.4%) |
| History of hypercholesterolemia | 1648 (82.1%) | 0.114 | 432 (85.0%) | 0.001 | 922 (93.6%) |
| Smoking within last 30 days | 1241 (61.8%) | 0.878 | 316 (62.2%) | 0.002 | 528 (53.7%) |
| Sleep apnoea | 49 (2.5%) | 0.366 | 16 (3.2%) | 0.001 | 96 (9.8%) |
| Other comorbidities | |||||
| History of renal dysfunction | 143 (7.2%) | 0.004 | 56 (11.1%) | 0.004 | 163 (16.6%) |
| History of heart failure | 30 (1.5%) | 0.027 | 15 (2.9%) | 0.001 | 96 (9.8%) |
| Prior MI | 242 (12.1%) | 0.240 | 71 (13.9%) | 0.001 | 230 (23.4%) |
| AMI treatment | |||||
| Coronary revascularisation (PCI/CABG) | 1595 (79.4%) | 0.003 | 433 (85.2%) | 0.412 | 823 (83.6%) |
| Diagnostic angiography | 1900 (94.6%) | 0.001 | 498 (98.0%) | 0.001 | 914 (92.8%) |
| Discharge medications | |||||
| Aspirin at discharge | 1948 (98.3%) | 0.459 | 492 (98.8%) | 0.032 | 934 (96.9%) |
| Statin prescribed | 1827 (93.4%) | 0.054 | 471 (95.7%) | 0.397 | 914 (94.7%) |
| Beta-blocker prescribed | 1779 (95.1%) | 0.042 | 459 (97.3%) | 0.506 | 905 (36.6%) |
| ACE or ARB prescribed | 1193 (65.8%) | 0.021 | 329 (71.5%) | 0.005 | 709 (78.3%) |
| Non-pharmacological interventions prescribed at discharge | |||||
| Diet counselling | 1850 (92.1%) | 0.659 | 471 (92.7%) | 0.524 | 904 (91.8%) |
| Activity guidelines | 1818 (90.5%) | 0.005 | 480 (94.5%) | 0.001 | 876 (88.9%) |
| Outpatient cardiac rehab prescribed | 874 (43.5%) | 0.132 | 240 (47.2%) | 0.035 | 409 (41.5%) |
| Diabetes education | 166 (8.3%) | 0.001 | 91 (17.9%) | 0.001 | 647 (65.7%) |
| Weight management counselling | 753 (37.5%) | 0.713 | 195 (38.4%) | 0.065 | 427 (43.4%) |
| Smoking cessation counselling | 1391 (69.3%) | 0.339 | 363 (71.5%) | 0.001 | 613 (62.2%) |
| Participated in in-patient cardiac rehab | 519 (25.9%) | 0.010 | 160 (31.5%) | 0.162 | 276 (28.0%) |
| Clinical characteristics of AMI | |||||
| Coronary occlusion ≥50% (documented by coronary angiography) | 0.233 | 0.013 | |||
| Yes | 1637 (81.5%) | 438 (86.2%) | 852 (86.5%) | ||
| No | 244 (12.2%) | 50 (9.8%) | 56 (5.7%) | ||
| Unknown | 127 (6.3%) | 20 (4.0%) | 77 (7.8%) | ||
| ST-segment elevation | 1077 (53.6%) | 0.188 | 289 (56.9%) | 0.001 | 445 (45.2%) |
| Initial heart rate, median (IQR) | 78.0 (23.0) | 0.003 | 81.0 (25.0) | 0.001 | 88.0 (26.0) |
| Peak troponin, median (IQR) | 8.1 (31.5) | 0.549 | 8.6 (25.3) | 0.001 | 4.9 (20.4) |
| Ejection fraction <40% | 189 (9.6%) | 0.098 | 60 (12.2%) | 0.818 | 119 (12.6%) |
| Time to presentation >6 hours | 767 (38.3%) | 0.999 | 193 (38.3%) | 0.001 | 506 (51.6%) |
| Other clinical characteristics | |||||
| Baseline admission HbA1c (%), median (IQR) | 5.6 (0.5) | 0.001 | 6.3 (1.2) | 0.001 | 8.5 (3.8) |
| 1 month HbA1c (%), median (IQR) | 6.0 (0.5) | 0.001 | 6.8 (0.4) | 0.001 | 7.6 (2.0) |
| Diabetes types | |||||
| Type 1 | NA | NA | 104 (10.6%) | ||
| Type 2 | NA | NA | 742 (75.3%) | ||
| Unknown | NA | NA | 139 (14.1%) | ||
| Peak creatinine, median (IQR) | 0.90 (0.3) | 0.004 | 0.90 (0.3) | 0.994 | 0.90 (0.4) |
| Psychosocial and behavioural characteristics | |||||
| Social support via ESSI | 26.1 (5.3) | 0.151 | 25.7 (5.4) | 0.082 | 25.2 (5.7) |
| Stress via PSS | 25.2 (9.6) | 0.773 | 25.3 (9.8) | 0.711 | 27.25 (9.9) |
| Depressive symptom via PHQ-9 | 6.9 (6.1) | 0.007 | 7.8 (6.4) | 0.001 | 9.34 (6.8) |
| Self-reported socioeconomic status | |||||
| Have health insurance | 1631 (81.2%) | 0.014 | 388 (76.4%) | 0.213 | 780 (79.2%) |
| How difficult is it for you to get medical care when needed? | 0.129 | 0.052 | |||
| Extremely difficult | 172 (8.6%) | 57 (11.2%) | 109 (11.1%) | ||
| Some difficulty | 310 (15.5%) | 69 (13.6%) | 182 (18.5%) | ||
| Little/no difficulty | 1525 (75.9%) | 382 (75.2%) | 692 (70.4%) | ||
| Have your medical costs been an economic burden to you over the past year? | 0.047 | 0.001 | |||
| Severe burden | 207 (10.3%) | 72 (14.2%) | 187 (19.0%) | ||
| Some burden | 352 (17.5%) | 86 (16.9%) | 241 (24.5%) | ||
| Little/no burden | 1448 (72.2%) | 350 (68.9%) | 555 (56.5%) | ||
| Avoided healthcare services due to cost (Y/N) | 517 (25.8%) | 0.001 | 174 (34.3%) | 0.273 | 365 (37.1%) |
| How often have you not taken a medication that your doctor prescribed because of the cost? | 0.009 | 0.001 | |||
| Always | 67 (3.3%) | 30 (5.9%) | 52 (5.3%) | ||
| Sometimes | 251 (12.5%) | 74 (14.6%) | 235 (23.9%) | ||
| Rarely to never | 1689 (84.2%) | 404 (79.5%) | 696 (70.8%) | ||
Data are given as mean (SD), median (IQR) or no. (%).
P value numbers in bold denote statistical significance at the p<0.05 level.
*Unadjusted p values were testing for differences in baseline characteristics between patients with AMI with newly diagnosed diabetes and no diabetes.
†Unadjusted p values were testing for differences in baseline characteristics between patients with AMI with newly diagnosed diabetes and established diabetes.
AMI, acute myocardial infarction; CABG, coronary artery bypass grafting; CVD, cardiovascular disease; ESSI, ENRICHD social support instrument; HbA1c, glycated haemoglobin; LDL, low-density lipoprotein; MI, myocardial infarction; NA, not available; PCI, percutaneous coronary intervention; PHQ-9, Patient Health Questionnaire-9; PSS, Perceived Stress Scale; TG, triglycerides.