Abdul Rehman Abid, Nadeem Hayat Mallick, Ahmad Shahbaz, Siraj Munir Ahmed Tarin.
In-hospital outcome of acute myocardial infarction (ST segment elevation type) in diabetics and non-diabetics
J Coll Physicians Surg Pak Sep 2005;15(9):524-7.
Nishtar Hospital, Multan

Objective: To evaluate the in-hospital mortality and complications of acute myocardial infarction in diabetic and nondiabetic patients. Design: Descriptive study. Place and Duration of Study: Coronary Care Unit and Cardiology Ward of Nishtar Hospital, Multan from 1st October 2002 till 15th May 2003. Patients and Methods: Four hundred and forty-eight (448) consecutive patients who fulfilled the inclusion criteria were studied while they were admitted to the hospital. Patients were divided into two groups of diabetics and non-diabetics depending on the presence of diabetes mellitus. In-hospital mortality and complications were compared between the two groups by Chi-square method. Results: Diabetic patients presented in more advanced Killip class as 32(26.7%) patients presented in Killip class II, 13(10.8%) patients presented in Killip class III and 6(5%) patients presented in Killip class IV. In the non-diabetic group, 68(20.7%), 24(7.3%) and 11(3.4%) patients presented in these Killip classes respectively (p<0.042). The total in-hospital mortality was 17%. Mortality was 28(23.3%) in diabetics and 48(14.6%) in non-diabetics (p<0.03). In-hospital mortality was almost double in diabetics as compared to non-diabetics. Mechanical complications were observed in 42(35%) patients in diabetic group and 80(24.4%) patients in non-diabetic group. Left ventricular failure was the most commonly observed mechanical complication. Electrical complications were observed in 84(70%) diabetic and 162(49.4%) non-diabetic patients (p<0.205). Conclusion: In patients with acute myocardial infarction, presence of diabetes mellitus was associated with worse inhospital outcome leading to increased mortality and complications as compared to non-diabetic patients.

Category: Cardiology
Keywords: Myocardial Infarction. Diabetes Mellitus. Diabetic Complications. Ischemic Heart Disease.

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