Who are the enemies? Diabetes mellitus ? a major risk factor for ischaemic myocardial injury: new directions in the management of acute coronary syndromes in the diabetic patient (original) (raw)

PREVALENCE AND SIGNIFICANCE OF DIABETES IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

2000

SUMMARY Data from the World Health Organization show that there is an increase in the morbidity and mortality caused by ischemic coronary disease. Diabetes has been confirmed as an independent risk factor in the development of coronary disease. The aim of this study was to determine the effect and role of diabetes mellitus in patients suffering from acute myocardial infarction

Prevalence of Diabetes Mellitus in Myocardial Infarction Patients -An Observational Study

Journal of Biomedical and Pharmaceutical Research

Background: According to studies, having diabetes is a risk factor in and of itself for developing cardiovascular disease. The World Health Organization (WHO) reports that the worldwide burden of death and morbidity attributable to cardiovascular disease is increasing. Material & Methods: The present observational research was conducted at our tertiary care institution and lasted six months, from June to November 2022. We recruited 100 AMI patients upon receipt of written informed permission. Results: 60% of research participants had normal blood sugar levels, 25% previously knew they had diabetes mellitus, 11% had the diagnosis identified while they were hospitalized, and 4% experienced stress-related blood sugar elevations. Conclusion: In addition to being a predictor of prognosis and recurrences, elevated blood sugar was connected to acute cardiovascular problems, especially in those with acute myocardial infarction.

A Study of Mortality and Complication Rate of Diabetics with Myocardial Infarction

1993

ABSTRACT: Diabetes Mellitus is a common endocrine disorder. Ii increases and accelerates atherogenesis. Cardiovascular complications dominate the lives of diabetic patients, with most succumbing to coronary artery disease. We studied the mortality and major complication rate of diabetics who developed an acute myocardial infarction. 26.4% of patients died during the index infarction and overall about 79% had at least one significant myocardial infarction related complication. Diabetic patients with a myocardial infarction need to be treated as a special group with close monitoring of their blood sugar levels to reduce the incidence of mortality and complications. Efforts should be made to prevent diabetes mellitus by the avoidance or treatment of obesity and by encouraging physical activity.

Diabetes mellitus and cardiovascular disease

European Journal of Internal Medicine, 2002

Diabetes is associated with a high incidence and poor prognosis of cardiovascular disease, and with high short- and long-term mortality. Adequate treatment of cardiovascular disorders and aggressive management of coexisting risk factors have proved to be at least as effective in diabetic as in nondiabetic patients in randomized, controlled studies. Indeed, treating diabetic patients with cardiovascular disease results in a larger absolute risk reduction than in nondiabetic subjects. Nevertheless, diabetic patients often receive inadequate therapy, which may, to a certain extent, explain their poor prognosis. Recommendations for the treatment of diabetic patients with acute myocardial infarction should include beta-blockers, aspirin, and ACE-inhibitors in all patients in whom no specific contraindications exist. Fibrinolysis should be administered when indicated, and the benefits of improving glycemic control should not be forgotten either. In patients with multi-vessel disease who need revascularization, when selecting the type of procedure, the superiority of surgical revascularization over angioplasty should be borne in mind. Even heart transplantation should be included as a therapeutic option since there are no data to support the exclusion of patients on account of their diabetes. Finally, coexisting risk factors should be intensively treated through lifestyle intervention, with or without drug therapy, in order to achieve secondary prevention goals.

Type 2 diabetes and coronary heart disease: Focus on myocardial infarction

Current Diabetes Reports, 2009

Individuals with type 2 diabetes are more likely to experience a myocardial infarction and have worse outcomes compared with nondiabetic individuals. The underlying pathophysiology of the atherosclerotic process is accentuated but not signifi cantly different in patients with type 2 diabetes. In addition, the prothrombotic state associated with diabetes may also contribute to the higher incidence of and worse prognosis after myocardial infarction. Diffi culties of re-establishing vessel patency by thrombolytic or mechanical means due to diffuse coronary disease, altered vessel structure, and prothrombotic state can contribute to the high morbidity and mortality in these patients. The concurrent metabolic dysfunction contributes to impair compensatory mechanisms, which can increase infarct size and cause more impairment of left ventricular function. Aggressive medical therapy and careful modulation of glucose metabolism in the acute and follow-up phase of a myocardial infarction may favorably infl uence outcome.

In-Hospital Outcome Of Acute Coronary Syndrome In Patients With Diabetes Mellitus

University Heart Journal, 2009

Diabetes mellitus adversely influences the outcome of acute coronary syndrome. This study evaluated the in-hospital outcome of acute coronary syndrome in patients with diabetes mellitus. In this prospective observation study 130 patients with acute coronary syndrome were enrolled. They were divided into diabetic and nondiabetic group. Diabetic patients were taken as case and nondiabetic patients as control. Outcome parameter studied were in-hospital mortality, cardiogenic shock, congestive heart failure, different arrhythmias and recurrent angina. In this study, one third (32%) of the patients were diabetic with mean age 58±10.0 years vs. 53.0±13.6 years in diabetic and nondiabetic group, respectively. Majority of the patients in both groups were male. Congestive heart failure and arrhythmias were more common in case group compared to those in control group (19% vs. 13.6% p=0.424; 23.8% vs. 13.6%, p= 0.148, respectively). Cardiogenic shock developed in 7.1% of diabetic patients and 8% of nondiabetic patients. In hospital mortality was 7.1% and 5.7% in diabetic and nondiabetic group, respectively. Recurrent angina developed only in diabetic patients. Therefore, diabetic patients with acute coronary syndrome encountered more in-hospital adverse outcome.