Association of diabetes mellitus and acute myocardial infarction: a study in a semi urban centre

Background: Acute myocardial infarction is one of the very common ailments, that quite often ends in mortality. The risk factors for AMI has been identified as smoking, alcoholism, high cholesterol, obesity, left ventricular hypertrophy, high triglyceride levels and diabetes mellitus. This study was done to evaluate diabetes as a risk factor for the incidence of acute myocardial infarction in our area.Methods: Demographic details such as age, sex, height, weight, BMI, blood pressure, details of alcoholism or smoking were taken. Physical examination was conducted for all the patients. Previous clinical and medical history was taken for all the patients. The predictors for calculation of 10 years risk factor for SCORE were age, sex, smoking, cholesterol and triglyceride levels and blood pressure.Results: The mean age of the males was 66.1±2.7 and women was 68.8±4.9. 27.3% of the males and 29.4% of the females were obese while 34.6% of males and 32.4% of females were overweight. The mean random blood sugar among the diabetic patients was around 143.5 mg/dL, and in the non-diabetics it was 84.4mg/dL. Out of the 48 diabetic patients, 32 of them (66.7%) had a previous history of MI while in non-diabetes, 53.7% had a previous MI attack.Conclusions: It is essential for the early detection of diabetes and control of the sugar levels, so as to reduce the risk of cardiovascular ailments, since diabetes is one of the independent risk factors.

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Prevalence and prognostic impact of left ventricular systolic dysfunction after acute myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.1796 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T.J Jernberg ◽

E.O Omerovic ◽

E.H Hamilton ◽

K.L Lindmark ◽

L.D Desta ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Myocardial Infarction ◽

Atrial Fibrillation ◽

Risk Factor ◽

Reperfusion Therapy ◽

Left Ventricular ◽

Funding Source ◽

Additional Risk Factor ◽

Additional Risk

Abstract Background Left ventricular dysfunction after an acute myocardial infarction (MI) is associated with poor outcome. The PARADISE-MI trial is examining whether an angiotensin receptor-neprilysin inhibitor reduces the risk of cardiovascular death or worsening heart failure (HF) in this population. The aim of this study was to examine the prevalence and prognosis of different subsets of post-MI patients in a real-world setting. Additionally, the prognostic importance of some common risk factors used as risk enrichment criteria in the PARADISE-MI trial were specifically examined. Methods In a nationwide myocardial infarction registry (SWEDEHEART), including 87 177 patients with type 1 MI between 2011–2018, 3 subsets of patients were identified in the overall MI cohort (where patients with previous HF were excluded); population 1 (n=27 568 (32%)) with signs of acute HF or an ejection fraction (EF) <50%, population 2 (n=13 038 (15%)) with signs of acute HF or an EF <40%, and population 3 (PARADISE-MI like) (n=11 175 (13%)) with signs of acute HF or an EF <40% and at least one risk factor (Age ≥70, eGFR <60, diabetes mellitus, prior MI, atrial fibrillation, EF <30%, Killip III-IV and STEMI without reperfusion therapy). Results When all MIs, population 1 (HF or EF <50%), 2 (HF or EF <40%) and 3 (HF or EF <40% + additional risk factor (PARADISE-MI like)) were compared, the median (IQR) age increased from 70 (61–79) to 77 (70–84). Also, the proportion of diabetes (22% to 33%), STEMI (38% to 50%), atrial fibrillation (10% to 24%) and Killip-class >2 (1% to 7%) increased. After 3 years of follow-up, the cumulative probability of death or readmission because of heart failure in the overall MI population and in population 1 to 3 was 17.4%, 26.9%, 37.6% and 41.8%, respectively. In population 2, all risk factors were independently associated with death or readmission because of HF (Age ≥70 (HR (95% CI): 1.80 (1.66–1.95)), eGFR <60 (1.62 (1.52–1.74)), diabetes mellitus (1.35 (1.26–1.44)), prior MI (1.16 (1.07–1.25)), atrial fibrillation (1.35 (1.26–1.45)), EF <30% (1.69 (1.58–1.81)), Killip III-IV (1.34 (1.19–1.51)) and STEMI without reperfusion therapy (1.34 (1.21–1.48))) in a multivariable Cox regression analysis. The risk increased with increasing number of risk factors (Figure 1). Conclusion Depending on definition, post MI HF is present in 13–32% of all MI patients and is associated with a high risk of subsequent death or readmission because of HF. The risk increases significantly with every additional risk factor. There is a need to optimize management and improve outcomes for this high risk population. Figure 1 Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Novartis

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ACUTE MYOCARDIAL INFARCTION

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.03.1476 ◽

2016 ◽

Vol 23 (03) ◽

pp. 293-297

Author(s):

Rafaqat Malik ◽

Shazma Begum ◽

Muhammad Nazar Afridi

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Risk Factor ◽

Modifiable Risk Factors ◽

Common Risk Factor ◽

Cardiology Department ◽

The World ◽

History Of

The frequency of modifiable risk factors of acute myocardial infarction variesgreatly in different countries and populations of the world. Objective: To find out the frequencyof modifiable risk factors in patients with acute myocardial infarction. Design: Cross-sectionalstudy. Setting: Cardiology Department. Ayub Teaching Hospital Abbottabad, Period: 1st Jan2015 and 30th June 2015. Material and Methods: A total of 224 patients of acute myocardialinfarction Patients were enquired about the presence of hypertension, diabetes mellitus,smoking and family history of ischemic heart disease. Fasting blood sugar and lipid profilewere recorded. Results: Out of 224, 90.6% patients had at least one risk factor. Hypertensionwas found to be the most common risk factor (55.4%), followed by smoking (43.8%) andDiabetes Mellitus (27.2%). Dyslipidemia was found to be the least common (23.2%) risk factor.Conclusion: Hypertension is the most common modifiable risk factor in patients of acutemyocardial infarction, followed by smoking and diabetes.

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Effect of sulfonylureas on attenuation of electrocardiographic ST- segment elevation during an acute myocardial infarction in diabetics

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20180969 ◽

2018 ◽

Vol 7 (4) ◽

pp. 579

Author(s):

Bapugouda Sahebagouda Patil ◽

Naser Ashraf Tadvi

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Control Group ◽

Diabetic Patients ◽

Study Group ◽

St Segment Elevation ◽

St Segment ◽

Significant Difference ◽

The Mean

Background: Sulfonylureas are primarily used in the treatment of diabetes mellitus act by inhibiting ATP sensitive potassium ATP (K-ATP) channels. Similar channels are also present are also present in heart venticular muscle. Previous studies reveal that these drugs are able to reduce the electrocardiographic ST- segment elevation changes during an acute myocardial infarction. Hence, the present study was designed to evaluate the attenuating effect of sulfonylureas on ST- segment elevation in diabetic patients presenting with acute myocardial infarction.Methods: This cross sectional study included 73 diabetic patients presenting with the signs and symptoms of acute myocardial infarction of less than 24 hours duration along with CPK levels of more than 25 IU/L. Of them 5 were excluded from the study. The remaining 68 patients were included in the study, out of which 36 patients were in the study group (sulfonylurea group), and 32 patients were in the control group (non-sulfonylurea group).Results: No statistically significant difference was seen in the demographic parameters like age, sex, duration of diabetes mellitus and CPK levels (p>0.05). Among 68 patients 38 patients were diagnosed as STEMI. The mean magnitude of ST-elevation in the study group (n=16) was 2.3±0.12 and in control group (n=22) patients it was 3.7±0.33. The percentage of NSTEMI was significantly higher in study group compared to control. Statistically significant difference (p<0.05) was seen only between CPK level of range 25 and 100IU/L and mean magnitude of ST-segment elevation in STEMI patients. Significant difference in the mean magnitude of ST-segment elevation was observed in case of females among the study and control groups (p<0.05).Conclusions: Sulfonylureas drugs play a significant role in attenuation of ST-segment in diabetic patients presenting with acute myocardial infarction. Further, large multicentric studies are required to confirm the exact correlation between sulfonylureas and ST-segment.

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Incidence and risk factors of delirium after percutaneous coronary intervention in individuals hospitalised for acute myocardial infarction: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-044564 ◽

2020 ◽

Vol 10 (12) ◽

pp. e044564

Author(s):

Kaizhuang Huang ◽

Jiaying Lu ◽

Yaoli Zhu ◽

Tao Cheng ◽

Dahao Du ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Systematic Review ◽

Acute Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Risk Factor ◽

Meta Analysis ◽

Coronary Intervention ◽

Cochrane Library ◽

Percutaneous Coronary

IntroductionDelirium in the postoperative period is a wide-reaching problem that affects important clinical outcomes. The incidence and risk factors of delirium in individuals with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI) has not been completely determined and no relevant systematic review and meta-analysis of incidence or risk factors exists. Hence, we aim to conduct a systematic review and meta-analysis to ascertain the incidence and risk factors of delirium among AMI patients undergoing PCI.Methods and analysesWe will undertake a comprehensive literature search among PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL and Google Scholar from their inception to the search date. Prospective cohort and cross-sectional studies that described the incidence or at least one risk factor of delirium will be eligible for inclusion. The primary outcome will be the incidence of postoperative delirium. The quality of included studies will be assessed using a risk of bias tool for prevalence studies and the Cochrane guidelines. Heterogeneity of the estimates across studies will be assessed. Incidence and risk factors associated with delirium will be extracted. Incidence data will be pooled. Each risk factor reported in the included studies will be recorded together with its statistical significance; narrative and meta-analytical approaches will be employed. The systematic review and meta-analysis will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus there is no requirement for ethics approval. The study will provide an up to date and accurate incidence and risk factors of delirium after PCI among patients with AMI, which is necessary for future research in this area. The findings of this study will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42020184388.

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Cardiovascular events in patients with type 2 diabetes

The British Journal of Diabetes ◽

10.1177/1474651402002001s0201 ◽

2002 ◽

Vol 2 (1_suppl) ◽

pp. S4-S8

Author(s):

Erland Erdmann

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Risk Factor ◽

Adverse Effects ◽

Cardiovascular Events ◽

Left Ventricular ◽

Diabetic Patients ◽

Increased Risk

Diabetes is a common risk factor for cardiovascular disease. Coronary heart disease and left ventricular dysfunction are more common in diabetic patients than in non-diabetic patients, and diabetic patients benefit less from revascularisation procedures. This increased risk can only partly be explained by the adverse effects of diabetes on established risk factors; hence, a substantial part of the excess risk must be attributable to direct effects of hyperglycaemia and diabetes. In type 2 diabetes, hyperinsulinaemia, insulin resistance and hyperglycaemia have a number of potential adverse effects, including effects on endothelial function and coagulation. Risk factor modification has been shown to reduce the occurrence of cardiovascular events in patients with diabetes; indeed, diabetic patients appear to benefit more in absolute terms than non-diabetic patients. There is thus a strong case for intensive treatment of risk factors, including insulin resistance and hyperglycaemia, in patients with type 2 diabetes.

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Trends of risk factors in coronary surgery

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1010570m ◽

2010 ◽

Vol 138 (9-10) ◽

pp. 570-576 ◽

Cited By ~ 4

Author(s):

Bogoljub Mihajlovic ◽

Svetozar Nicin ◽

Nada Cemerlic-Adjic ◽

Katica Pavlovic ◽

Slobodan Dodic ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Emergency Operation ◽

Female Gender ◽

Left Ventricular ◽

Neurological Dysfunction ◽

Chi Square ◽

Percutaneous Coronary ◽

The Mean ◽

Cabg Patients

Introduction. In current era of widespread use of percutaneous coronary interventions (PCI), it is debatable whether coronary artery by-pass graft (CABG) patients are at higher risk. Objective. The aim of the study was to evaluate trends in risk profile of isolated CABG patients. Methods. By analysing the EuroSCORE and its risk factors, we reviewed a consecutive group of 4675 isolated CABG patients, operated on during the last 8 years (2001-2008) at our Clinic. The number of PCI patients was compared to the number of CABG patients. For statistical analyses, Pearson?s chi-square and ANOVA tests were used. Results. The number of PCI increased from 159 to 1595 (p<0.001), and the number of CABG from 557 to 656 (p<0.001). The mean EuroSCORE increased from 2.74 to 2.92 (p=0.06). The frequency of the following risk factors did not change over years: female gender, previous cardiac surgery, serum creatinine >200?mol/l, left ventricular dysfunction and postinfarct ventricular septal rupture. Chronic pulmonary disease, neurological dysfunction, and unstable pectoral angina declined significantly (p<0.001). Critical preoperative care declined from 3.1% in 2001 to 0.5 % in 2005, than increased and during the last 3 years did not change (2.3%). The mean age increased from 56.8 to 60.7 (p<0.001) and extracardiac arteriopathy increased from 9.2% to 22.9% (p<0.001). Recent preoperative myocardial infarction increased from 11% to 15.1% (p=0.021), while emergency operations increased from 0.9% to 4.0% (p=0.001). Conclusion. The number of CABG increases despite the enlargement of PCI. The risk for isolated CABG given by EuroSCORE increases over years. The risk factors, significantly contributing to higher EuroSCORE are: older age, extracardiac arteriopathy, recent myocardial infarction and emergency operation.

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RISK FACTORS ASSOCIATED WITH THE OCCURRENCE OF EARLY COMPLICATIONS OF ACUTE MYOCARDIAL INFARCTION AFTER CARDIO-INTERVENTION TREATMENT

Wiadomości Lekarskie ◽

10.36740/wlek202006132 ◽

2020 ◽

Vol 73 (6) ◽

pp. 1245-1251

Author(s):

Iryna A. Holovanova ◽

Grygori A. Oksak ◽

Iryna M. Tkachenko ◽

Maxim V. Khorosh ◽

Mariia M. Tovstiak ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cox Regression ◽

Risk Indicators ◽

Interventional Treatment ◽

Early Complications ◽

Cox Regression Analysis ◽

Intervention Treatment

The aim of our study was to identify the main risk factors for the occurrence of early complications of acute myocardial infarction after cardio-interventional treatment and to evaluate prognostic risk indicators. Materials and methods: Risk factors of myocardial infarction were determined by copying the case history data and calculating on their basis of the odds ratio and ±95% confidence interval. After it, we made a prediction of the risk of early complications of AMI with cardiovascular intervention by using a Cox regression that took into account the patient’s transportation time by ambulance. Results: Thus, the factors that increase the chances of their occurrence were: summer time of year; recurrent myocardial infarction of another specified localization (I122.8); the relevance of the established STEMI diagnosis; diabetes mellitus; renal pathology; smoking; high rate of BMI. Factors that reduce the chances of their occurrence: men gender – in 35%; the age over of 70 – by 50%; the timely arrival of an emergency medical team – by 55%. The factors that increase the chances of their occurrence were: age over 70 years; subsequent myocardial infarction of unspecified site; diabetes mellitus. Using of a Cox regression analysis, it was proved that the cumulative risk of early complications of AMI with cardio-intervention treatment increased from the 10th minute of ambulance arrival at place, when ECG diagnosis (STEMI), presence of diabetes mellitus, smoking and high BMI. Conclusions: As a result of the conducted research, the risk factors for early complications of AIM with cardio-interventional treatment were identified.

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Abstract 558: Association of Chronic Kidney Disease and Diabetes Mellitus with 5-Year Outcomes after Acute Myocardial Infarction

Circulation ◽

10.1161/circ.118.suppl_18.s_580-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Kazuoki Dai ◽

Masaharu Ishihara ◽

Ichiro Inoue ◽

Takuji Kawagoe ◽

Yuji Shimatani ◽

...

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Chronic Kidney Disease ◽

Survival Rate ◽

Kidney Disease ◽

Independent Predictor ◽

Diabetic Patients ◽

Kaplan Meier ◽

Significant Difference

Several studies have shown that both chronic kidney disease (CKD) and diabetes mellitus are risk factors for mortality in patients with acute myocardial infarction (AMI). This study was undertaken to investigate influence of CKD on the prognostic significance of diabetes in patients with AMI. Between January 1996 and December 2005, 888 patients with AMI underwent coronary angiography within 24 hours after the onset of chest pain. CKD was difined estimated glomerular filtration rate (eGFR) of less than 60.0 ml/minute/1.73 m 2 of body-surface area (stage3–5). Kaplan-Meier method was used to compare 5-year survival of diabetic and non-diabetic patients, in the presence (n=337) or absence (n=551). Kaplan-Meier curves for 5-year survival rate are shown in Figure . In the absence of CKD, there was no significant difference in 5-year survival rate between patients with diabetes and those without (93 % v.s. 94 %, p=0.82). In patients with CKD, however, diabetes was associated with lower 5-year survival rate (65 % v.s. 87 %, p<0.001). Multivariate analysis showed that diabetes was an independent predictor for 5-year survival in patients with CKD (OR 3.2, 95%CI 1.8–5.8, p=0.0002), but not in patients without CKD (OR 1.1, 95%CI 0.4–2.5, p=0.82). Diabetes mellitus was an independent predictor for death after AMI in patients with CKD. Aggressive treatment after AMI should be advocated in diabetic patients with CKD.

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