Routine blood test-derived biochemical profile associated with acute myocardial infarction in patients with diabetes mellitus

Abstract Diabetes mellitus (DM) increases acute myocardial infarction (AMI) risk, but current risk scores are not designed for near-term AMI. Routine blood tests (RBTs), including complete blood count, renal, and liver function panels, provide objective systemic measures, yet their multivariable associations with near-term AMI in DM are not quantified. This retrospective case-control study included records from adults with DM from the Hong Kong Hospital Authority Data Collaboration Laboratory database (2000–2020). AMI cases had RBTs 7–30 days pre-AMI, and controls had RBTs within one-month post-DM diagnosis. Nineteen RBT components were analyzed using logistic regression after collinearity reduction. Among 197,602 patients (39,359 AMI cases), the AMI group was older and had more cardiovascular comorbidities. Multivariable analysis revealed independent positive associations for creatinine (OR 1.17), albumin (OR 1.40), and globulin (OR 1.55), while mean corpuscular hemoglobin concentration (OR 0.59) and alkaline phosphatase (OR 0.82) showed inverse associations. This hypothesis-generating analysis establishes an interpretable biochemical profile of RBT components independently associated with near-term AMI in DM patients. Prospective external validation is required before these findings can inform clinical practice.