Thrombolytic treatment lowers the mortality of patients with acute myocardial infarction (MI), and the benefit is as pronounced in diabetic patients as in non-diabetic patients. Despite this knowledge, pharmaco-epidemiological studies have reported that diabetic patients receive thrombolytic treatment less often than non-diabetic patients. The reason for this is uncertain. It has been claimed that diabetic individuals suffering acute MI do not receive optimal treatment.¹ An alternative explanation is long delays from symptom onset to admission among diabetic patients, thus rendering them less suitable for thrombolysis.² We decided to investigate more accurately the eligibility for thrombolytic treatment among diabetic patients.

PATIENTS AND METHODS

We drew a sample of patients from 16 hospitals in Norway who were discharged with a diagnosis of acute MI (ICD 10 I21 and I22). Patients included in the study had been hospitalised during three consecutive months between August 1999 and January 2000. Information on patient characteristics, use of thrombolytics and other cardiovascular drugs during the hospital stay, and accurate information of the ECGs on admission was collected from the hospital records 3–4 months after admission. Only patients confirmed with diabetes at admission to hospital were counted as diabetic patients. More details about the methods are given …