Effect of Diabetic Status on Morbidity and Mortality following Acute Myocardial Infarction

Abstract

The morbidity and mortality from acute myocardial infarction (AMI) is high in diabetics. This may be due to more extensive myocardial damage as diabetics have more severe coronary artery disease (CAD). This short term propective study evaluated the clinical course of AMI in diabetic patients. Patients admitted with AMI were assessed for glycemic status, clinical events and left ventricular function on echocardiography. Fifty diabetic and sixty non diabetic patients were enrolled. the baseline characteristics were well matched. More diabetic patients were in killip calss II and III [(56% vs 21%) P< 0.05] class IV [(12% VS 6%) p=NS] and had higher mortality [14% function assessed on echocardiography LVFs 20+ 8% VS 25 + 5%) P< 0.05]. diabetics had higher fasting glucose [(164 + 68 vs 90 + 13mg/dl) p<0.001] and higher fructosamine level [(445 + 152 vs 226 + 50 micro mol/l) p< 0001). Diabetes was consideree adequately controlled in 12 patients against 38 patients with fructosamine level [(250 + 25 vs 494 + 168 micro mol / l) p< 0.001) and fasting glucose [(105 + 12 vs 175 + 25 mg/dl) p< 0.01]. Heart failure was more common in uncontrolled diabetics than controlled diabetics [(70% vs 34%) p< 0.05] but there was no difference in mortality. Diabetic status in general and uncontrolled diabetes in particular is associates with higher morbidity and left vetricular dysfunction.