FREQUENCY OF DIABETES MELLITUS IN PATIENTS WITH ACUTE CORONARY SYNDROME
AbstractBackground: Diabetes mellitus is a major risk factor for atherosclerosis which eventually causes cardiovascular disease specially affecting coronary arteries. Patients with diabetes have a risk for coronary events similar to that of patients without diabetes who have already had an event, and conversely many patients with established coronary artery disease suffer from diabetes or its pre-states. The objective of study was to determine the frequency of diabetes mellitus in patients presenting with acute coronary syndrome in our setup. Methods: This cross sectional study was conducted in the Department of Cardiology and Medical unit-B of Ayub Medical College, Abbottabad from October 22, 2009 to April 22, 2010. All patients of either gender presenting with acute coronary syndrome above 25 years of age were included in the study by consecutive non-probability sampling. Results: Two hundred and fifty patients were included in study. Of these 161 (64.4%) were males and 89 (34.6%) were females. The mean age of the study participants was 57.75 years. Frequency of diabetes mellitus was 31.6% and most (62%) of the known diabetics with ACS were having poor glycaemic control. The coronary event which was seen in the majority (74%) of patients was ST segment elevation myocardial infarction. Conclusion: The frequency of diabetes mellitus in this study was significant as one out of every third patient with acute coronary syndrome was diabetic.Keywords: Diabetes mellitus, cardiovascular disease, acute coronary syndrome
Khan DA, Saeed M, Khan FA. Is glycemic control in patients with type-2 diabetes in Rawalpindi improving? J Ayub Med Coll Abbottabad 2009;21(1):62–5.
Iqbal F, Naz R. Pattern of diabetes mellitus in Pakistan; An overview of the problem. Pak J Med Res 2005;44(1):59–64.
Khowaja LA, Khuwaja AK, Cosgrove P. Cost of diabetes care in out-patient clinics of Karachi, Pakistan. BMC Health Serv Res 2007;7:189.
Goff DC Jr, Gerstein HC, Ginsberg HN, Cushman WC, Margolis KL, Byington RP, et al. Prevention of cardiovascular disease in persons with type-2 diabetes mellitus: current knowledge and rationale for the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Am J Cardiol 2007;99(12A):4i–20i.
Franklin K, Robert J, Spencer F, Klein W, Budaj A, Brieger D, et al. Implications of diabetes in patients with coronary syndromes. The global registry of acute coronary events. Arch Intern Med 2004;164:1457–63.
Donahoe SM, Stewart GC, McCabe CH, Mohanavelu S, Murphy SA, Cannon CP, et al. Diabetes and mortality following acute coronary syndromes. JAMA 2007;298:765–75.
Kazim SF, Itrat A, Butt NW, Ishaq M. Comparison of cardiovascular disease patterns in two data sets of patients admitted at tertiary care public hospital in Karachi five years apart. Pak J Med Sci 2009;25:55–60.
Ghaffar A, Reddy KS, Singhi M. Burden of non-communicable diseases in South Asia. BMJ 2004;328:807–10.
Mudespacher D, Radovanovic D, Camenzind E, Essig M, Bertel O, Erne P, et al. Admission glycemia and outcome in patients with acute coronary syndrome. Diab Vasc Dis Res 2007;4:346–52.
Gasior M, Pres D, Stasik-Pres G, Lech P, Gierlotka M, Hawranek M, et al. Effect of blood glucose levels on prognosis in acute myocardial infarction in patients with and without diabetes, undergoing percutaneous coronary intervention. Cardiol J 2008;15:422–30.
Stranders I, Diamant M, van Gelder RE, Spruijt HJ, Twisk JWR, Heine RJ, et al. Admission blood glucose levels as risk indicator of death after myocardial infarction in patients with and without diabetes mellitus. Arch Intern Med 2004;164:982–8.
Hashimoto K, Ikewaki K, Yaga H, Nagasawa H, Imamoto S, Shibata T, et al. Glucose intolerance is common in Japanese patients with acute coronary syndrome who were not previously diagnosed with diabetes. Diabetes Care 2005;28:1182–6.
Kurowska M, Tarach JS, Dudzinska M, Kudicki J. High incidence of hyperglycemia and type-2 diabetes with acute coronary syndrome (ACS). Ann Univ Mariae Curie Sklodowska Med 2008;63:69–73.
Okosieme OE, Peter R, Usman M, Bolusni H, Suruliram P, George L, et al. Can admission and fasting glucose reliably identify undiagnosed diabetes in patients with acute coronary syndrome? Diabetes Care 2008;31:1955–9.
Sahibzada P, Khan AA, Sahibzada WA. Impact of hyperglycemia on morbidity and mortality of acute coronary syndromes and acute myocardial infarction. J Ayub Med Coll Abbottabad 2009;21(1):110–5.
Iqbal MJ, Azhar M, Javed MT, Tahira I. Study on ST-segment elevated acute myocardial infarction (STEMI) in diabetic and non-diabetic patients. Pak J Med Sci 2008;24:786–91.
Sheikh BA, Sheikh WM, Solangi GA, Sangi SA, Abro HA, Sheikh AM, et al. Diabetes mellitus (Diagnosed and undiagnosed) in acute medical infarction. Med Channel 2006;12:36–9.
Ishihara M, Inoue I, Kawagoe T, Shimatani Y, Kurisu S, Hata T, et al. Is admission hyperglycemia in non-diabetic patients with acute myocardial infarction a surrogate for previously undiagnosed abnormal glucose tolerance? Eur Heart J 2006;27:2413–9.
Chrysohoou C, Panagiotakos DB, Pitsavos C, Kokkinos P, Marinakis N, Stefanadis C, et al. Gender differences on the risk evaluation of acute coronary syndromes; The CARDIO 2000 Study. Prev Cardiol 2003;6(2):71–7.
Morgan EN, Boyle EM Jr, Yun W, Kovacich JC, Canty TG Jr, Chi E, et al. Platelet-activating factor acetylhydrolase prevents myocardial ischemia-reperfusion injury. Circulation 1999;100:(19 Suppl):II365–8.
Tipoo FA, Quraishi AR, Najaf SM, Kazmi KA, Jafary F, Dhakam S, et al. Outcome of cardiogenic shock complicating acute myocardial infarction. J Coll Physicians Surg Pak 2004;14(1):6–9.
Liu J, Zhao D, Liu Q, Wang W, Sun JY, Wang M, et al. Study on the prevalence of diabetes mellitus among acute coronary syndrome inpatients in multiprovincial study in China. Zhonghua Liu Xing Bing Za Zhi 2008;29:526–9
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.