A Study of First Episode of Acute Myocardial Infarction in Type 2 Diabetes Mellitus Patients

A comparative study of first episode of acute myocardial infarction in diabetic and non-diabetic patients

Authors

  • Dr.Anup M Vegad
  • Dr.Maulik S Varu
  • Dr.Mahesh M Rathod
  • Dr. Hitesh A Jani

DOI:

https://doi.org/10.70284/njirm.v3i3.2022

Keywords:

Coronary artery disease, Acute myocardial infarction, Diabetics, Non diabetics

Abstract

Background & objectives: Diabetes mellitus, both insulin and non insulin dependent, is an independent risk factor for coronary artery disease which have a larger infarct size, atypical ischemic symptoms and more post infarct complication than non diabetic patients.So the present study was undertaken with following objectives: (1) To study occurrences of various ischemic symptoms, complications and mortality between diabetics and non diabetics. (2) To find out the relation between duration of diabetes, glycemic control and mortality due to first episode of acute myocardial infarction. Methods: Total 100 cases of acute myocardial infarction included comprising 50 type 2 diabetic patients and 50 non diabetic patients. Patients having first episode of acute myocardial infarction and who is already known case of diabetes mellitus were included. Results: Highest incidence of first episode of acute myocardial infarction in diabetics was occurring at earlier age than non diabetics and more incidences in obese persons and diabetic females. There was less frequent occurrence of chest pain and perspiration in diabetics. Higher incidence of recurrent angina, bundle branch block, atrio-ventricular block and heart failure was noted in diabetics than non diabetics. 30 days mortality was higher in patients having Random blood sugar >198 gm% on admission and diabetes since more than 5 years. Interpretation & conclusion: In the present study, the overall conclusion has been made that in diabetic patients acute myocardial infarction occurs at earlier age, there are atypical ischemic symptoms and also higher incidence of complications and higher mortality rate. So in every patient of acute myocardial infarction glycaemia status should be assessed on admission and hyperglycaemia should be aggressively treated.

References

1. J. Michael Gaziano, Global burden of cardiovascular disease, Peter Libby, Robert O. Bonow, Douglas L. Mann, Braunwald’s Heart Disease. 8th edition, 2007; 1, Pg-1
2. Mc. Kinlay J. Marceay L. US public health and 21st century: diabetes mellitus Lancet 2000; 356:757-761
3. Alvin C. Powers, cardiovascular mortality and morbidity in diabetes mellitus, Harrison’ principles of internal medicine 17th edition, 2008; Part II, chapter 338.
4. Mak KH, Molitermo DJ, Granger CB, et al. influence of diabetes mellitus on clinical outcome in thrombolytic era of acute myocardial infarction: GUSTO-I investigators (Global Utilization Of Streptokinase and Tissue Plasminogen Activator for occluded coronary arteries). J Am Coll Cardiol. 1997; 30(1): 171-179.
5. Malmberg K, Yusuf S, Gerstein HC, et al. Impact of diabetes on long term prognosis in patients with unstable angina and non-Q-wave myocardial infarction: results of OASIS (Organization to Assess Strategies for Ischemic Syndromes) registry. Circulation, 2000; 102(9):1014-1019.
6. Franklin K, Goldberg RJ, Spencer F, et al. implications of diabetes in patients with acute coronary syndromes; the Global Registry of Acute Coronary Events. Arch Intern Med.2004; 164(13): 1457-1463.
7. Eagle KA, Lim MJ, Dabbous OH, et al. a validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6 month post discharge death in an international registry. JAMA. 2004; 291(22):2727-2733.
8. Richman PB, Brogan GX, Nashed AN, et al. Clinical characteristics of diabetic Vs. nondiabetic who rule in for acute myocardial infarction, Acute Emergency Medicine, 1999; Nov. Vol.6;7, 719-723.
9. Mackenzie et al. Comparison of treatment and outcome in diabetics and nondiabetics, Can J. cardiovascular Nurs 2001, 11:25-34. Archieves of Onternal Medicine, 2004, May Vol. 164, no.9.
10. K. Malmberg and L. Ryden, et al. Myocardial Infarction on patients with diabetes mellitus. Europian Heart Journal 1988 9(3):259-264.
11. D.K. Mcguire, H. Emanaelsson, C.B. Granger, E. Magnus Ohman, D.J. Moliterno et al. Influence of diabetes mellitus on clinical outcomes across the spectrum of acute coronary syndromes. Finding from Gusto 11b trial Europian Heart Journal (2000)21, 1750-1758.
12. J sala, R. Masia, F.J. Gonazalea, REGICOR study Journal of Epidemiology and Community Health-2002;56:707.

Downloads

Published

2012-08-31

How to Cite

Vegad, D. M., Varu, D. S., Rathod, D. M., & Jani, D. H. A. (2012). A Study of First Episode of Acute Myocardial Infarction in Type 2 Diabetes Mellitus Patients: A comparative study of first episode of acute myocardial infarction in diabetic and non-diabetic patients. National Journal of Integrated Research in Medicine, 3(3), 11–14. https://doi.org/10.70284/njirm.v3i3.2022

Issue

Section

Original Articles

Most read articles by the same author(s)