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July 23, 2026BMC Public HealthOpen Access

Diabetes-associated short-term mortality after first-onset acute myocardial infarction: age- and residence-specific patterns in an underserved region

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Why the study?

Does diabetes increase short-term mortality in patients with first-onset acute myocardial infarction across different age and geographic residence strata?

Population

1,591 patients with first-onset acute myocardial infarction (AMI) in an underserved region (Eastern Taiwan)

Comparison

Diabetes mellitus (exposure) vs No diabetes mellitus

Design

Cohort

Follow-up

30 days

Key result

Diabetes was associated with higher 30-day mortality after first-onset AMI, with a significantly stronger association among younger patients (aOR 3.83 vs 1.60; p-for-interaction=0.045).

Authors

DTDiyana Jing Yi TeohTHTsung‐Cheng HsiehJHJen-Che Hsieh

Discussion

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Overview

May warrant age- and residence-specific vigilance in underserved AMI care; leaves open causal pathways and intervention targets for prospective study.

Key Points

  • This study aims to explore the short-term mortality risks associated with diabetes and age in patients experiencing their first acute myocardial infarction.
  • Conducted a 16-year retrospective cohort study of 1,591 first-onset AMI patients in Eastern Taiwan.
  • Analyzed short-term mortality categorized by pre-hospital and post-arrival mortality.
  • Estimated adjusted odds ratios across strata defined by age group (younger vs. older) and residence (urban vs. rural).
  • Short-term mortality was higher among older patients with diabetes (17.9%) compared to younger patients (8.2%).
  • Diabetes increased short-term mortality risk in younger patients (aOR: 3.83) and older patients (aOR: 1.60; p-for-interaction = 0.045).
  • Among younger rural patients, diabetes correlated with an even higher short-term mortality (aOR: 4.24).

Study Design

Type

Cohort (n=1,591)

Multicenter

No

Structured PICO

Does diabetes increase short-term mortality in patients with first-onset acute myocardial infarction across different age and geographic residence strata?

P
Population
1,591 patients with first-onset acute myocardial infarction from a single center in Eastern Taiwan, evaluated for 30-day mortality in a 16-year retrospective cohort study.
E
Exposure
Diabetes mellitus (exposure)
C
Comparator
No diabetes mellitus
O
Outcome
Overall short-term mortality (30-day mortality)hard clinical

Main Result

Effect estimate: aOR 3.83 (younger) vs 1.60 (older)

p-value: p=0.045

Diabetes significantly increases short-term mortality after first-onset AMI, particularly among younger patients and those living in rural areas, highlighting a highly vulnerable subgroup in underserved regions.

Limitations

  • Exploratory subgroup analyses were based on limited event counts
  • Lack of direct systems-of-care measures to determine geographic and emergency-care access factors
  • Limited event counts in exploratory subgroup analyses

Cite This Study

Teoh et al. (2026) conducted a cohort in first-onset acute myocardial infarction (n=1,591). Diabetes vs. Non-diabetes was evaluated on overall short-term mortality (30-day mortality) (aOR 3.83 (younger) vs 1.60 (older), p=0.045). Diabetes was associated with higher 30-day mortality after first-onset AMI, with a significantly stronger association among younger patients (aOR 3.83 vs 1.60; p-for-interaction=0.045).

synapsesocial.com/papers/6a61af8bfaa9903c5116a5b1https://doi.org/10.1186/s12889-026-28437-3
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 11420-P: Temporal Trends and Sociodemographic Disparities in Acute Myocardial Infarction Outcomes among Hospitalized Patients with Diabetes Mellitus: Impact of the COVID-19 Pandemic in California, 2016–20222026
  2. 2Trends and Disparities in Mortality Due to Non-Insulin Dependent Diabetes Mellitus and Acute Myocardial Infarction: A 23-Year Analysis from 1999 to 20222025
  3. 3A Retrospective Study of Disparities in Mortality Due to Diabetes Mellitus Over a 22-Year Period in the United States2025
  4. 4Anemia and diabetes related mortality in older adults: Geographic and temporal trends in the US, 1999-20232025
  5. 5Mortality Trends Related to Diabetes Mellitus and Heart Failure: A Retrospective Study2025