CLINICAL AND MEDICAL HISTORY FEATURES OF ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH DIABETES MELLITUS. EPIDEMIOLOGY STUDY
https://doi.org/10.38109/2225-1685-2017-4-52-61
Abstract
The aim of the present study was to investigate clinical and medical history features of the onset, course, and short-term outcomes of acute myocardial infarction (AMI) in patients with type 2 diabetes mellitus (T2DM). Original data were obtained from analytical information database of the World Health Organization epidemiology program “Acute Myocardial Infarction Register” for 2014 to 2015. A total of 1157 cases of AMI, registered in Tomsk in 2014-2015 except prehospital death episodes, were analyzed. Type 2 diabetes mellitus was present in medical history of 259 (22.4%) patients with AMI. Age-gender structure of patients with diabetes mellitus showed that women (60.2% and 35.4%, respectively; p<0.001) and individuals older than 60 years (76.1% and 57.8%, respectively; p<0.001) prevailed. Obtained results demonstrated that AMI in the presence of T2DM was characterized with more severe cardiovascular medical history, severe AMI course with frequent atypical onset, a few electrocardiographic findings, and very high lethality. The vast majority of fatal AMI cases were registered when patients were in general hospitals. The presence of significant number of women and older individuals among T2DM patients as well as high frequency of cases with atypical clinical onset of the disease and complicated medical history hampered AMI diagnosis. All above-said suggests the necessity of increase awareness of physicians working in general hospitals and emergency departments in regard to individuals with T2DM as potentially vulnerable to AMI development.
About the Authors
S. A. Okrugin
Cardiology Research Institute of Tomsk National Research Medical Center of the Russian Academy of Medical Sciences
Russian Federation
Russian Federation
MD, PhD, Senior Research Scientist of the Department of General Cardiology and Cardiovascular Epidemiology
111a Kievskaya Str., Tomsk 634012, Russia
Tel: +7-382-2-56-52-75, Fax: +7-382-2-55-50-57
A. A. Garganeeva
Cardiology Research Institute of Tomsk National Research Medical Center of the Russian Academy of Medical Sciences
Russian Federation
Russian Federation
MD, PhD, Professor, Head of the Department of General Cardiology and Cardiovascular Epidemiology
111a Kievskaya Str., Tomsk, 634012, Russia
Tel: +7-382-2-56-52-75, Fax: +7-382-2-55-50-57
E. A. Kuzheleva
Cardiology Research Institute of Tomsk National Research Medical Center of the Russian Academy of Medical Sciences
Russian Federation
Russian Federation
MD, PhD, Research Scientist of the Department of General Cardiology and Cardiovascular Epidemiology
111a Kievskaya Str., Tomsk 634012, Russia
Tel: +7-382-2-56-52-75, Fax: +7-382-2-55-50-57
References
1. Dedov I.I. Diabetes mellitus: Development of diagnostic, treatment, and prevention technologies. Sakharni Diabet, 2010; 3: 6-13. [in Russian].
2. Kokorin S.V., Krugliy L.B., Mkrtumyan A.M. Clinicalmorphological features, prognosis, and treatment tactics of acute coronary syndrome in patients with type 2 diabetes mellitus. Sakharni Diabet, 2013; 2: 36-42. [in Russian].
3. Mitkovskaya N.P., Statkevich T.V., Zhuk A.V. et al. Diabetic mellitus and metabolic syndrome as risk factor of the development of complications in myocardial infarction. Meditsinsky Zhurnal, 2012; 2: 83-86. [in Russian].
4. Kokorin S.V., Stogov A.V., Mkrtumyan A.M. Acute left ventricular insufficiency in patients with type 2 diabetes mellitus. The International Journal of Interventional Cardioangiology, 2015; 41: 48-56. [in Russian].
5. Demidov V.I., Konina E.A., Mayorova M.V., Mishina I.E. Prognostic evaluation of myocardial infarction outcome in patients with diabetes mellitus. Journal of New Medical Technologies, 2011; 4: 133-135. [in Russian].
6. Iarek-Martynova I.R., Shestakova M.V. Cardiovascular diseases in patients with diabetes mellitus. CardioSomatika, 2010; 1: 46-50. [in Russian].
7. Dzhakhangirov T.Sh. Diabetes mellitus as a problem of current cardiology. Kardiologiia, 2005; 10: 55-61. [in Russian].
8. Betig Z., Mazur N.A., Metelitsa V.I. Comparative data from myocardial infarction registries in Moscow and Berlin. Moscow: Meditsina. 1977: 166-193. [in Russian].
9. Valensi P., Paries J., Brulport-Ceresier V. Predective Value of Silent Myocardial Ischemia for Cardiac Events in Diabetic Patients. Influence of age in a French multicenter study. Diabet. Care, 2005; 11: 2722-2727.
10. Sima A.A., Thomas P.K., Ishii D., Vinik A. Diabetic neuropathies. Diabetologia, 1997; 3: 74-77.
11. Kutovoy V.I. Specifics of clinical manifestation and medical care delivery in elderly patients with acute myocardial infarction. Emergency Medicine, 2013; 49(2): 117-121. [in Russian].
12. Belik V.E., Gruzdeva O.V., Karetnikova V.N. Glycemia at admission and peculiarities of in-hospital period in patients with ST segment elevation myocardial infarction. Siberian Medical Journal (Irkutsk), 2014; 4: 25-28. [in Russian].
13. Erlikh A.D., Gratsiansky N.A. Acute coronary syndrome in patients with diabetes mellitus: Real-life practice of Russian hospitals. Sakharni Diabet, 2012; 2: 27-31. [in Russian].
14. David L.A., Grosu A.A. Impaired glucose tolerance in patients with acute myocardial infarction. Kardiologiia, 2013; 9; 15-20. [in Russian].
15. Garganeeva A.A., Okrugin S.A., Borel K.N., Tukish O.V. Causes of death in patients with acute myocardial infarction in general hospitals. Klinicheskaya Meditsina, 2015; 6: 73-76. [in Russian].
16. Garganeeva A.A., Okrugin S.A., Borel K.N. Prehospital and hospital lethality from acute myocardial infarction in Tomsk according to data of Acute Myocardial Infarction Register. Kardiologicheskiy Vestnik, 2014; 3: 64-68. [in Russian].
17. Garganeeva A.A., Okrugin S.A., Borel K.N., Parshin E.A. Demographic situation impact on epidemiology of coronary pathology in urban population of the West Siberian region. Russian Journal of Cardiology, 2014: 11(115); 62-66. [in Russian]
Review
For citations:
Okrugin S.A., Garganeeva A.A., Kuzheleva E.A. CLINICAL AND MEDICAL HISTORY FEATURES OF ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH DIABETES MELLITUS. EPIDEMIOLOGY STUDY. Eurasian heart journal. 2017;(4):52-61. https://doi.org/10.38109/2225-1685-2017-4-52-61
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