Abstract:
Background. Type 2 diabetes mellitus (T2DM) triples the risk of acute myocardial
infarction (AMI) and raises mortality by 30–50%. A global prevalence of 9.3% boosts AMI
incidence and severity, demanding sustained, individualized therapy and ongoing
monitoring to ensure optimal long-term clinical outcomes.
Objective(s). Highlighting the impact of type 2 diabetes mellitus on the clinical course and
prognosis of acute myocardial infarction to underpin tailored therapy strategies and
effective secondary prevention.
Materials and methods. A comprehensive synthesis of peer-reviewed literature published
from 2020 to 2025 was conducted by searching PubMed, Scopus, Medscape, ScienceDirect
and UpToDate for the terms “type 2 diabetes mellitus”, “acute myocardial infarction” and
“cardiovascular complications”. The review delineates how T2DM precipitates AMI and
worsens post-AMI prognosis.
Results. Type 2 diabetes mellitus (T2DM) worsens acute myocardial infarction (AMI),
generating atypical clinical presentations in 36% of cases versus 24% in non-diabetics.
Antero-septal STEMI was registered in 52% versus 41%, while angiographic coronary
thrombosis occurred in 29% against 14%. Cardiogenic shock developed in 6.1% versus
3.2%. Mean left-ventricular ejection fraction dropped to 43 ± 8% in diabetics versus 49 ±
7%. Early mortality doubled (41% vs 20%; p<0.05). At 12 months, major cardiovascular
events (recurrent myocardial infarction) reached 12% versus 5%, confirming the harmful
impact of chronic hyperglycemia on coronary lesions.
Conclusion(s). Analysis confirms the hypothesis: type 2 diabetes aggravates AMI. Strict
control of fasting glucose < 7.2 mmol/L, HbA1c ≤ 7 %, BP < 130/80 mmHg, LDL-c < 1.4
mmol/L, maintaining normal weight, and continuous cardio-metabolic surveillance before
and after AMI lower recurrence and mortality.
