Prevalence of diabetes in patients with myocardial infarction: a study in a tertiary care centre


  • Lalatendu Mohanty Department of Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
  • Debananda Sahoo Department of Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
  • Dayanidhi Meher Department of Endocrinology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
  • Panchanan Sahoo Department of Cardiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India



Acute myocardial infarction, Diabetes mellitus, Prevalence, Risk factors


Background: Diabetics experience a greater mortality during the acute phase of myocardial infarction (MI) and a higher morbidity in the postinfarction period. This study was conducted to assess the prevalence of diabetes as a risk factor for acute myocardial infarction.

Methods: Detailed demographic details such as age, gender, weight, BMI, blood pressure, smoking and alcohol details, previous clinical and medical history were noted for all the patients. Blood was collected from the patients for random blood glucose levels and HbA1c levels. On the 2nd and the 5th days of admission, fasting blood glucose levels were measured.

Results: 63.5% patients were males and only 36.5% of them were females with the average age being around 66 years. Most of the patients who were admitted to the hospital with MI were obese or overweight with elevated cholesterol and triglyceride levels. Out of the 104 patients, 59 (56.7%) had no diabetics, 29 (27.9%) were known diabetics. 11 (10.6%) of them were identified as diabetic during the hospitalization.

Conclusions: The chronic and acute hyperglycaemia associated to acute coronary syndromes, mainly in acute myocardial infarction is an independent and determinant factor in the outcome for patients with and without diabetes mellitus.


Jacoby R, Nesto R. Acute myocardial infarction in the diabetic patient: pathophysiology, clinical course and prognosis. J Am Coll Cardiol. 1992;20:736-44.

Aronson D, Rayfield E, Cheseboro J. Mechanisms determining course and outcome of diabetic patients who have had acute myocardial infarction. Ann Intern Med. 1997;126:296-306.

Kannel WB, McGee DL. Diabetes and glucose tolerance as risk factors for cardiovascular disease: the Framingham Study. Diabetes Care. 1979;2:20-6.

Woodfield SL, Lundergan CF, Reiner JS, Greenhouse SW, Thompson MA, Rohrbeck SC, et al. Angiographic findings and outcome in diabetic patients treated with thrombolytic therapy for acute myocardial infarction: the GUSTO-I experience. J Am Coll Cardio. 1996;l28:1661-9.

Hochman JS, Tamis JE, Thompson TD, Weaver WD, White HD, Van de, et al. Sex, clinical presentation, and outcome in patients with acute coronary syndromes. global use of strategies to open occluded coronary arteries in acute coronary syndromes iib investigators. N Engl J Med. 1999;341:226-32.

Berger JS, Elliott L, Gallup D, Roe M, Granger CB, Armstrong PW, et al. Sex differences in mortality following acute coronary syndromes. J Am Med Asso. 2009;302:874-82.

Vaccarino V, Parsons L, Every NR, Barron HV, Krumholz HM. Sex-based differences in early mortality after myocardial infarction national registry of myocardial infarction 2 participants. N Engl J Med. 1999;341:217-25.

Reddy KS, Yusuf S. Emerging epidemic of cardiovascular disease in developing countries. Circulation. 1998;97:596-601.

Nguyen HN, Fujiyoshi A, Abbott RD, Miura K. Epidemiology of cardiovascular risk factors in Asian countries. Circ J. 2013;77:2851-9.

Kosiborod M, Inzucchi SE, Krumholz HM. Glucometrics in patients hospitalized with acute myocardial infarction: defining the optimal outcomes-based measure of risk. Circulation. 2008;117:1018-27.

Kosiborod M, Rathore SS, Inzucchi SE. Admission glucose and mortality in elderly patients hospitalized with acute myocardial infarction: implications for patients with and without recognized diabetes. Circulation. 2005;111:3078-86.

Capes SE, Hunt D, Malmberg K, Gerstein HC. Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet. 2000;355:773-78.

Bartnik M, Ryden L, Ferrari R. Euro heart survey investigators. the prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe. The euro heart survey on diabetes and the heart. Eur Heart J. 2004;25:1880-90.

Norhammar A, Tenerz A, Nilsson G. Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet. 2002;359:2140-4.

Rytter L, Troeslsen S, Neilsen BH. Prevalence and mortality of acute myocardial infarction in patients with diabetes. Diabetes Care. 1985;8:230-4.

Stone P, Muller J, Hartwell T. The effect of diabetes mellitus on prognosis and serial left ventricular function after acute myocardial infarction: contribution of both coronary disease and left ventricular dysfunction to the adverse prognosis. J Am Coll Cardiol. 1989;14:49-57.

Czyzk A, Krolewski A, Szablowska S, Alot A, Korezynski J. Clinical course of myocardial infarction among diabetic patients. Diabetes Care. 1989;38:350-7.

Lundberg V, Stegmayr B, Asplund K, Eliasson M, Huhtsaari F. Diabetes as a risk factor for myocardial infarction: population and gender perspectives. J Int Med. 1997;241:485-92.

Tenerz A, Lonnberg I, Berne C, Nilsson G, Leppert J. Myocardial infarction and prevalence of diabetes mellitus. European Heart Journal. 2001;22:1102-10.

Thom T, Haase N, Rosamond W. 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;113:85-151.

Oswald GA, Corcoran S, Yudkin JS. Prevalence and risk of hyperglycemia and undiagnosed diabetes in patients with acute myocardial infarction. Lancet. 1984;1:1264-7.

Lim HS, Macfadyen RJ, Lip GY. Diabetes mellitus, the renin-angiotensin-aldosterone system, and the heart. Arch Intern Med. 2004;164:1737-48.

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

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

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

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

Lopez Y, Paloma MJ, Rifon J, Cuesta B, Paramo JA. Measurement of prethrombotic markers in the assessment of acquired hypercoagulable states. Thromb Res. 1999;93:71-8.

Carr ME. Diabetes mellitus: a hypercoagulable state. J Diabetes Complications. 2001;15:44-54.

Collier A, Rumley A, Rumley AG, Paterson JR, Leach JP, Lowe GD, Small M. Free radical activity and hemostatic factors in NIDDM patients with and without micro albuminuria. Diabetes. 1992;41:909-13.

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

Singh KG, Singh SD, Bijoychandra K, Kamei P, Chingkhei, Bijay M. A study on the clinical profile of stroke in relation to glycaemic status of patients. J Indian Academy Clin Med. 2014;15(3):177-81.

Gracy CS, French JM. Castlidge NEF, Venables GM, Jumes DFW. Increasing age, diabetes mellitus and recovery from stroke. Postgraduate Medical Journal. 1989;65:720-4.

Kiers L, Davis SM, Larkins R. Stroke topography and outcome in relation to hyperglycaemia and diabetes. Journal Neurology, Neurosurgery, Psychiatry. 1992;55(4):263-70.

Woo J, Lam CW, Kay R, Wong AH, Teoh R, Nicholls MG. The influence of hyperglycemia and diabetes mellitus on immediate and 3-month morbidity and mortality after acute stroke. Arch Neurol. 1990;47:1174-7.

Dandona P, Chaudhuri A, Ghanim H, Mohanty P. Effect of hyperglycemia and insulin in acute coronary syndromes. Am J Cardiol. 2007:99(11);12-8.

Haffner SM, Lehto S, Ronnemaa T, Pyorala 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 Engl J Med. 1998;339:229-34.






Original Research Articles