Jahanbakhsh Samadikhah, Seyed Hadi Hakim, Ali Reza Yaghoubi, Rezvanieh Salehi, Azin Alizadeh Asl, Rasoul Azarfarin.
Effects of Diabetes Mellitus on outcome of patients with first acute Myocardial Infarction.
Rawal Med J Jan ;32(2):131-4.

Objectives: To evaluate the effects of diabetes mellitus (DM) on outcome and survival of patients with first acute Myocardial Infarction (AMI). Methods: In 500 patients (358 men and 142 women), 74 (12.6%) were diabetic, and rest of them were non– diabetic. All diabetic patients were divided in to two groups, Group A included 13 patients with type 1 DM and the group B included 61 patients with type 2 DM. Results: Age–Adjusted mortality in one year follow-up for women with DM was 22%, and significantly higher than 13% in women without DM, (relative risk (RR) 1.69 and 95% CI 1.21 to 2.06). Mortality rate for men with DM (21%) and without DM (16%) was also significantly different (RR 1.31 and 95% CI 1.05- 1.62). Painless AMI occurred in15.4% of patients with type 1 and 14.4% of patients with type 2. One year mortality rate in both type 1 and 2 were 19.6% and 21.3% respectively (p>0.05). According to angiographic data, diabetic patients had more involved arteries than non diabetics (mean 2.62 vs. 2.07 vessels; P<0.05). Left ventricular function study demonstrated 34.03% of diabetic patients had lower (<40%) ejection fraction (EF), while 17.6% of nondiabetic patients had EF<40% (p<0.05). Conclusion: Our results emphasis the role of DM as a risk factor of severity of coronary artery disease and as a predictor of adverse outcome after first AMI. (Rawal Med J 2007;32:131-134).

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