DOI: http://dx.doi.org/10.18203/2349-3933.ijam20183412

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

Jella Ramdas, Vasantha Jella

Abstract


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.


Keywords


Association, Diabetes mellitus, Myocardial infarction

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References


WHO. Geneva: World Health Organization; 2006. Guidelines for the treatment of malaria 2006.

Sadowski M, Janion-Sadowska A, Gąsior M, Gierlotka M, Janion M, Poloński L. Higher mortality in women after ST-segment elevation myocardial infarction in very young patients. Arch Med Sci. 2013;9(3):427-33.

Haffner SM, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Eng J Med. 1998;339(4):229-34.

Yudkin JS, Oswald GA. Hyperglycaemia, diabetes and myocardial infarction. Diabetic Med. 1987;4(1):13-8.

Lakhdar A, Stromberg P, McAlpine SG. Prognostic importance of hyperglycaemia induced by stress after acute myocardial infarction. Br Med J (Clinical research ed.). 1984;288(6413):288.

Tansey MJ, Opie LH. Plasma glucose on admission to hospital as a metabolic index of the severity of acute myocardial infarction. Canadian J Cardiol. 1986;2(6):326-31.

Malmberg K, Rydén L, Efendic S, Herlitz J, Nicol P, Waldenstrom A, et al, DIGAMI Study Group. Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year. J Am Colle Cardiol. 1995;26(1):57-65.

Partamian JO, Bradley RF. Acute myocardial infarction in 258 cases of diabetes. N Eng J Med. 1965;273(9):455-61.

De Backer G, Ambrosioni E, Borch-Johnsen K, Brotons C, Cifkova R, Dallongeville J, et al. European guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2003;24(17):1601-10.

Conroy RM, Pyörälä K, Fitzgerald AE, Sans S, Menotti A, De Backer G, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003;24(11):987-1003.

Schmidt MI, Duncan BB, Sharrett AR, Lindberg G, Savage PJ, Offenbacher S, et al, ARIC investigators. Markers of inflammation and prediction of diabetes mellitus in adults (Atherosclerosis Risk in Communities study): a cohort study. Lancet. 1999;353(9165):1649-52.

Barzilay JI, Abraham L, Heckbert SR, Cushman M, Kuller LH, Resnick HE, et al. The relation of markers of inflammation to the development of glucose disorders in the elderly: the cardiovascular health study. Diabetes. 2001;50(10):2384-9.

Freeman DJ, Norrie J, Caslake MJ, Gaw A, Ford I, Lowe GD, et al. C-reactive protein is an independent predictor of risk for the development of diabetes in the West of Scotland coronary prevention study. Diabetes. 2002;51(5):1596–600.

Ford ES. Leukocyte count, erythrocyte sedimentation rate, and diabetes incidence in a national sample of US adults. Am J Epidemiol. 2002;155(1):57-64.

Bulugahapitiya U, Siyambalapitiya S, Sithole J, Idris I. Is diabetes a coronary risk equivalent? Systematic review and meta‐analysis. Diabetic Med. 2009;26(2):142-8.

Gavin JR, Hughes H, Alberti KGMM, Davidson MB, DeFronzo RA, Drash A, et al. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 1997;20:1183-97.

Vaccarino V, Krumholz HM, Yarzebski J, Gore JM, Goldberg RJ. Sex differences in 2-year mortality after hospital discharge for myocardial infarction. Ann Internal Med. 2001;134(3):173-81.

Tenerz Å, Lönnberg I, Berne C, Nilsson G, Leppert J. Myocardial infarction and prevalence of diabetes mellitus. Is increased casual blood glucose at admission a reliable criterion for the diagnosis of diabetes?. Eur Heart J. 2001;22(13):1102-10.

Thom T, Haase N, Rosamond W, Howard VJ, Rumsfeld J, Manolio T, et al, for the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. heart disease and stroke statistics-2006 update: a report from the aha statistics committee and stroke statistics subcommittee. Circulation. 2006;113(6):e85-e151

Schargrodsky H, Rozlosnik J, Ciruzzi M, Ruffa R, Paterno C, Ardariz M, et al. Body weight and nonfatal myocardial infarction in a case-control study from Argentina. Social and preventive Med. 1994;39(3):126-33.

Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk: a systematic review and meta-analysis. J Am Colle Cardiol. 2010;56(14):1113-32.

Japan Arteriosclerosis Longitudinal Study (JALS) Group. Body Mass Index and risk of stroke and myocardial infarction in a relatively lean population. Circulation: Cardiovascular Quality Outcomes. 2010.

Strazzullo P, D'elia L, Cairella G, Garbagnati F, Cappuccio FP, Scalfi L. Excess body weight and incidence of stroke: meta-analysis of prospective studies with 2 million participants. Stroke. 2010;41(5):e418-26.

Park DW, Kim YH, Yun SC, Ahn JM, Lee JY, Kim WJ, et al. Association of body mass index with major cardiovascular events and with mortality after percutaneous coronary intervention. Circulation: Cardiov Intervent. 2013;6(2):146-53.

O’brien EC, Fosbol EL, Peng SA, Alexander KP, Roe MT, Peterson ED. Association of Body Mass Index and long-term outcomes in older patients with non-st-segment-elevation myocardial infarction: results from the crusade registry. circulation: Cardiovascular Quality Outcomes. 2014;7(1):102-9.

Stevens J, Cai J, Pamuk ER, Williamson DF, Thun MJ, Wood JL. The effect of age on the association between body-mass index and mortality. N Eng J Med. 1998;338(1):1-7.

Bender R, Jöckel KH, Trautner C, Spraul M, Berger M. Effect of age on excess mortality in obesity. JAMA. 1999;281(16):1498-504.

Lim HS, MacFadyen RJ, Lip GY. Diabetes mellitus, the renin-angiotensin-aldosterone system, and the heart. Arch Internal Med. 2004;164(16):1737-48.

Miller JA. Impact of hyperglycemia on the renin angiotensin system in early human type 1 diabetes mellitus. J Am Soc Nephrol. 1999;10(8):1778-85.

Spiro MJ, Kumar BR, Crowley TJ. Myocardial glycoproteins in diabetes: type VI collagen is a major PAS-reactive extracellular matrix protein. J Mol Cellular Cardiol. 1992;24(4):397-410.

Aronson D. Cross-linking of glycated collagen in the pathogenesis of arterial and myocardial stiffening of aging and diabetes. J Hypertension. 2003;21(1):3-12.

Basta G, Schmidt AM, De Caterina R. Advanced glycation end products and vascular inflammation: implications for accelerated atherosclerosis in diabetes. Cardiov Res. 2004;63(4):582-92.

Wallander M, Norhammar A, Malmberg K, Öhrvik J, Rydén L, Brismar K. Insulin-like growth factor binding protein 1 predicts cardiovascular morbidity and mortality in patients with acute myocardial infarction and type 2 diabetes. Diabetes Care. 2007;30:2343-8.