FREQUENCY OF NEWLY DIAGNOSED DIABETES MELLITUS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Authors

  • Umar Hayat
  • Mattiullah Khan
  • Nasir Hussain Shah Kazmi
  • Nasir Ali
  • Rab nawaz
  • Waqar A Mufti
  • Faisal Iftikhar Khan
  • Airaz Khan

Abstract

Background: Diabetes is a major cause of heart disease. Death rate for heart disease is about 2–4 times higher among adults with diabetes then among those without diabetes. In setting of acute Myocardial infarction hyperglycemia is associated with adverse out come even after numerous “cardiac” variable linked to the outcome are adjusted. Elevated plasma glucose at admission is predictor of long term and in hospital outcome in patients with acute Myocardial infarction. After acute myocardial infarction high admission blood glucose level are common with increased risk of death in subjects with or without diabetes. The objective of study was to determine the frequency of newly diagnosis diabetes presenting with acute myocardial infarction. Methods: This cross sectional study was conducted in department of Cardiology, Ayub Teaching Hospital from June to November 2014. All patients admitted to coronary care unit with acute myocardial infarction and who were not known diabetics were enrolled by consecutive non probability sampling. Patients of either gender were included Hospital. Descriptive statistics were used to determine the frequency of newly diagnosed diabetics. RESULT: Out of 91 enrolled patients in our study, 60 (65.9%) were male, 31 (34.1%) were female. 27 (29.6%) patients were newly diagnosed diabetics. CONCLUSION: The frequency of newly diagnosed diabetics is quite high in patients with acute myocardial infarction. Hence all patients were not known diabetics and present with acute myocardial infarction should be screened for new onset of diabetes.Keywords:  Newly diagnosed diabetes, Acute Myocardial infarction, diabetes mellitus

References

Global statistic report of non-communicable disease 2010, Geneva: World Health Organization; 2011. Available at: http://www.who.int/nmh/publications/ncd_report2010/en/

Mathers CD, loncar D. Projection of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006;3:e442.

Shera AS, Rafique G, Khwaja IA, Baqai S, Khan IA, King H. Pakistan National Diabetes Survey prevalence of glucose intolerance and associated factors in North West at Frontier Province (NWFP) of Pakistan. J Pak Med Assoc 1999;49:206–11.

Stranders I, Diamant M, van Gelder RE, Spruijt HJ, Twisk JW, Heine RJ, et al. Admission blood glucose level as risk indicator of death after myocardial infarction in patients with and without diabetes mellitus.; Arch Intern Med.2004;164:982–8.

Vetter NJ, Strange RC, Adans W, Oliver MF. Initial metabolic and hormonal response to acute myocardial infarction. Lancet 1974;1:284–8.

Oswald GA, Smith CC, Betteridge DJ, Yudkin JS. Determinants and importance of stress hyper glycemia in non diabetes patients with myocardial infarction. BMJ (Clin Res Ed) 1986;293:917-922.

Oliver MF, Opie LH. Effects of glucose in fatty acids in myocardial ischemia and arrhythmias. Lancet 1994;343:155–8

Bellodi G, M anicardi v, Malavasi V, Veneri L, Bernini G, Bossini P, et al. Hyperglycemia and prognosis of acute myocardial infarction in patients without diabetes mellitus. Am J Cardiol 1989;64:885–8.

Reaven JM. Banting lecture 1988: Role of insulin resistance in human disease. Diabetes 1988;37:1595–607.

Heine RJ, Dekker JM. Beyond post prandial hyperglycaemia: metabolic factors associated with the cardio vescular disease. Diabetologia 2002;45:461–75.

Haffner SM, Stern MP, Hazuda HP, Mitcheel BD, Patterson JK. Cardio vascular risk factors in confirmed pre diabetic indivudial: does the clock for coronary heart disease start ticking before the onset of clinical diabetes? JAMA 1990;263:2893–8

Gerstein HC, Yusuf S. Dysglycaemia and risk of cardio vascular disease. Lancet 1996;347:949–50.

Gersein HC. Is glucose a continuous risk factor for cardio vascular morality? Diabetes Care 1999;22:659–60.

Balkau B, Bertrais S, Ducimetiere P, Eschwege E. Is there a glycaemic threshold for mortality risk? Diabetes Care 1999;22:696–9.

Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, Harvey D. ESC/ACCF/AHA/WHF Expert Consensus Document: Third Universal Definition of Myocardial Infarction. Circulation 2012;126:2020–35.

Wahab NN, Cowden EA, Pearce NJ, Gardner MJ, Merry H. Cox JL, et al. Is blood glucose an independent predictor of mortality in acute myocardial infarction in the thrombolytic era? J Am Coll Cardiol 2002;40:1748–54.

Norhammar A, Tenerz A, Nilsson G, Hamsten A, Efendíc S, Rydén L, et al. Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet 2002;359:2140–4.

Chung EH, Curran PJ, Sivasankarian S. Chauhan MS, Gossman DE, Pyne CT, et al. Prevalence of metabolic syndrome in patients <45 years of age with acute myocardial infarction having precutaneous coronary intervention. Am J Cardiol 2007;100:1052–5.

O’Sullivan JJ, Conroy RM, Robinson K, Hickey N, Mulcahy R, In-hospital prognosis of patients with fasting hyperglycemia after first myocardial infarction. Diabetes care 1991;4:758–60.

Fava S, Aquilina O, Azzopardi J, Agius Muscat H, Fenche FF. The prognostic value of blood glucose in diabetic patients with acute myocardial infarction. Diabet Med 1996;13:80–3.

Mak KH , Mah PK, Tey BH, Sin FL, Chia G. Fasting blood sugar level: a determinant for in-hospital outcome in patients with first myocardial infarction and without glucose intolerance. Ann Acad Med Singapore 1993;22:291–5.

Capes SE. Hunt D. Malmberg K, Gerstein HC. Stress hyperglycemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet 2000;355:773–8.

Brownlee M, Cerami A, Viassara H. Advanced glycosylation and products in tissue and the biochemical basis of diabetic complications. N Engl J Med 1988;318:1315–21.

Jain SK, Nagi DK, Slavin BM, Lumb PJ, Yudkin JS. Insulin therapy in type 2 diabetic subjects suppresses plassminogen activator inhibitor (PAI-1) activity and proinsulin-like molecules independently of glycaemic control. Diabet Med 1993;10:27–32

Brownlee M, Cerami A, Viassara H. Advanced glycosylation and products in tissue and the biochemical basis of diabetic complications. N Engl J Med 1988;318:1315–21.

Kawano H, Motoyama T, Hirashima O, Hirai N, Miyao Y, Sakamoto T, et al. Hyperglycemia rapidly suppresses flow-mediated endothelium- vasodilatation of brachial artery. J Am Coll Cardiol 1999;34:146–54

Williams SB, Goldfine AB, Timimi FK, Ting HH, Roddy MA,Simonson DC, et al. Acute hyperglycemia attenuates endothelium-dependent vasodilatation in human in vivo. Circulation 1998;97:1695–1701.

Norhammar AM, Ryden L, Malamberg K, Admission plasma glucose independent risk factor for long term prognosis after myocardial infarction even in non-diabetic patients. Diabetic care 1999;22:1827–31.

Malmberg K, Norhammar A, Wedel H, Ryden L Glycometabolic state at admission: important risk marker of mortality in conventionally treated patients with diabetes mellitus and acute myocardial infarction: long-term results from the Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) study. Circulation 1999;99:2626–32.

Norhammar A, Tenerz A, Nilsson G, Hamsten A, Efendíc S, Rydén L, et al. Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet. 2002;359:2140–4

Tenerz A Lonnherg 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;22:1102–10.

Bolk J, Van der Ploeg TJ, Cornel JH, Arnold AE, Sepers J, Umans VA. Impaired glucose metabolism predicts mortality after a myocardial infarction. Int J Cardiol 2001;79:207–14

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2014-09-01

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