ABSTRACT
Diabetes mellitus (DM) currently affects more than 150 million people worldwide. It is usually associated with a number of metabolic and cardiovascular risk factors that contribute to a high rate of vascular events. Specifically, 80% of patients with DM will develop and possibly die from macrovascular disease and the risk of cardiovascular disease is two-to fourfold higher in DM patients than in non-DM patients. Indeed, a patient with DM has a high risk of experiencing a first myocardial infarction (MI) as someone without DM who has already had a MI. Up to 20% of all patients with an infarction have diabetes, and this figure is expected to increase. Moreover, up to 23% of DM patients with coronary heart disease were found to have silent ischemia and experienced poor outcomes following acute events (1,2). Diabetic patients who sustain a STEMI still have double mortality compared with nondiabetic patients. Diabetes was associated with impaired postprocedural TIMI 3 flow, myocardial blush grade, complete ST segment resolution, and more distal embolization (3).
