Diabetes mellitus significantly worsens outcomes after AMI, and recent findings reveal that its impact is particularly severe among younger patients. Data from the Korea Acute Myocardial Infarction Registry National Institute of Health (KAMIR-NIH), presented at the European Association for the Study of Diabetes (EASD) 2025, demonstrate a clear age-related disparity in post-AMI survival.

The study analyzed 12,600 patients hospitalized with AMI between 2011 and 2015. Participants were grouped as younger (<55 years) or older (≥55 years) adults and further classified by diabetes status. Over a three-year follow-up, diabetes was strongly associated with higher all-cause mortality (13% vs 6.8%; adjusted hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.14–1.53; P<0.001). Among younger adults, diabetes more than doubled mortality risk (adjusted HR 2.07; 95% CI 1.15–3.72; P=0.015), compared with a 25% increase in older adults (adjusted HR 1.25; 95% CI 1.08–1.46; P=0.004).

The significant interaction between age and diabetes (P for interaction = 0.008) highlights the need for early cardiovascular risk prevention and close follow-up in younger adults with diabetes after AMI.