Preview

Rational Pharmacotherapy in Cardiology

Advanced search

Features of the in-hospital course of myocardial infarction in patients with glucose metabolism disorders

https://doi.org/10.20996/1819-6446-2015-11-5-477-482

Full Text:

Abstract

Aim. To study the clinical course of acute myocardial infarction (MI) with ST segment elevation (STEMI) and the features of inpatient treatment in patients with and without diabetes mellitus (DM).
Material and methods. STEMI patients (n=83), who were hospitalized in 2014, were included into the study. The patients were divided into two groups according to the presence or absence of glucose metabolism disorders: Group 1 (patients with type 2 DM; n=38) and Group 2 (patients without glucose metabolism disorders; n=45). Baseline demographic, clinical, laboratory and instrumental characteristics of the patients, along with the features of hospital treatment, were studied. 

Results. In group 1 compared with group 2 hypertension was detected significantly more frequently (73.7% vs 49%; p<0.05), and a class of acute heart failure (Killip) at admission was higher (1.46±0.6 vs 1.23±0.57; p<0.05). STEMI was complicated by an acute left ventricular aneurysm 12% more often in patients of group 1 (p<0.05). The duration of inpatient treatment was also higher in patients of group 1 (18±4.1 vs 16±3.6 days; p<0.05).
Conclusion. Only 21% of the patients with DM and STEMI had adequate treatment of ischemic heart disease and a quarter of the patients in this group had no adequate DM therapy before the admission. Patients with DM had a higher incidence of in-hospital STEMI complications and a higher duration of inpatient treatment. 

About the Authors

B. U. Mardanov
State Research Centre for Preventive Medicine. Petroverigsky per. 10, Moscow, 101990 Russia
Russian Federation


M. N. Mamedov
State Research Centre for Preventive Medicine. Petroverigsky per. 10, Moscow, 101990 Russia
Russian Federation


M. N. Korneeva
State Research Centre for Preventive Medicine. Petroverigsky per. 10, Moscow, 101990 Russia
Russian Federation


R. G. Oganov
State Research Centre for Preventive Medicine. Petroverigsky per. 10, Moscow, 101990 Russia
Russian Federation


References

1. Prakash D., Kosiborod M., Barrett E. Hyperglycemia and Acute Coronary Syndrome: A Scientific Statement From the American Heart Association Diabetes Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2008; 117:1610-9.

2. Buse J.B., Ginsberg H.N., Bakris G.L. et al. Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation. 2007; 115:114-26.

3. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. European Journal of Preventive Eur J Prev Cardiol. 2015 Feb 16. pii: 2047487315569401. [Epub ahead of print].

4. Lipton JA, Barendse RJ, Van Domburg RT. Hyperglycemia at admission and during hospital stay are independent risk factors for mortality in high risk cardiac patients admitted to an intensive cardiac care unit. European Heart Journal: Acute Cardiovascular Care 2013; 2(4):306-13.

5. Imamura F, Mukamal KJ, Meigs JB. et al. Risk factors for type 2 diabetes mellitus preceded by β-cell dysfunction, insulin resistance, or both in older adults: the Cardiovascular Health Study. Am J Epidemiol 2013; 177(12):1418-29.

6. National guidelines on the diagnosis and treatment of patients with acute myocardial infarction with ST-segment elevation ECG. Kardiovaskulyarnaya Terapiya i Profilaktika 2007; 6 (8) Appendix 1: 1-28. In Russian (Национальные рекомендации по диагностике и лечению больных острым инфарктом миокарда с подъемом сегмента ST ЭКГ. Кардиоваскулярная терапия и профилактика 2007;6 (8) Приложение 1: 1-28)

7. Cleary PA, Orchard TJ, Genuth S, et al. The effect of intensive glycemic treatment on coronary artery calcification in type 1 diabetic participants of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study. Diabetes 2006;55:3556-65.

8. Nilsson PM, Cederholm J, Zethelius BR, et al. Trends in blood pressure control in patients with type 2 diabetes: data from the Swedish National Diabetes Register (NDR). Blood Press 2011;20:348-54.

9. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J 2013;34(39):3035-87.

10. Davis TE, Coleman RL, Holman RR. et al. Prognostic Significance of Silent Myocardial Infarction in Newly Diagnosed Type 2 Diabetes Mellitus. Circulation 2013; 127:980-7.

11. Strogin LG, Kornev KG, Panov EI. Rhythm disturbances and metabolic control in patients with type 2 diabetes. Kardiologiya 2005; 11:46-49. Russian (Строгин Л.Г., Корнева К.Г., Панова Е.И. Нарушения ритма и метаболический контроль у больных сахарным диабетом 2-го типа. Кардиология 2005; 11:46-49).

12. Anikin VV, Savin VV. The features of manifestations of the arrhythmias at CAD combined with type II diabetes. Problemy Endokrinologii 1999; 12:24-27. Russian (Аникин В.В., Савин В.В. Особенности проявления аритмий при стенокардии, сочетающейся с сахарным диабетом второго типа. Проблемы Эндокринологии 1999; 12:24-27).

13. Perkiomaki Juha, Olli-Pekka Piira, Samuli Lepojarvi et al. Arrhythmia Risk Profiles in Patients with Coronary Artery Disease: The Influence of Diabetes. Circulation 2012; 126:A11036

14. Morrow J.P., Katchman A., Ni-Huiping S. et al. Mice With Cardiac Overexpression of Peroxisome Proliferator–Activated Receptor γ Have Impaired Repolarization and Spontaneous Fatal Ventricular Arrhythmias. Circulation 2011;124:2812-21.

15. Bertoni AG, Akwo EA, Bleumke DA. et al. Myocardial Contraction Fraction, Diabetes, and Heart Failure: The Multi-Ethnic Study of Atherosclerosis. Circulation 2012; 125:AP243.

16. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J 2013;34(39):3035-87.

17. Fabbrini E, Sullivan S, Klein S. Obesity and nonalcoholic fatty liver disease: biochemical, metabolic and clinical implications. Hepatology 2010;51:679-689.

18. Kotseva K, Wood D, De Backer G, et al. EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries. Eur J Cardiovasc Prev Rehabil 2009;16:121-37.

19. Belen’kova Yu.A., Karetnikova V.N., Dyachenko A.O. et al. The effectiveness of percutaneous coronary intervention at ST-elevation myocardial infarction patients with impaired glucose tolerance and diabetes. Kardiologiya 2014; 11(54): 4-10. Russian. (Беленькова Ю.А., Каретникова В.Н., Дяченко А.О. и др. Эффективность чрескожного коронарного вмешательства у пациентов с инфарктом миокарда с подъемом сегмента ST на фоне нарушенной толерантности к глюкозе и сахарным диабетом. Кардиология 2014; 11(54): 4-10)

20. Westfall JM, Kiefe CI, Weissman NW et al. Does interhospital transfer improve outcome of acute myocardial infarction? A propensity score analysis from the Cardiovascular Cooperative Project. BMC Cardiovasc Disord 2008;8:22-9.

21. Bell CL, Davis J, Harrigan RC, Somogyi-Zalud E. et al. Factors associated with place of death for elderly Japanese-American men: the Honolulu Heart Program and Honolulu-Asia Aging Study. J Am Geriatr Soc 2009;57(4):714-8.

22. Popov D. Endothelial cell dysfunction in hyperglycemia: Phenotypic change, intracellular signaling modification, ultrastructural alteration, and potential clinical outcomes. Int Jour of Diab Mellitus 2010; 2: 189-95.

23. Lamekes B.A., Hermanides J., Devries J.H. et al. Hyperglycemia: a prothrombotic factor? Journal of Thrombosis and Haemostasis. 2010; 8:1663-9.

24. Song P., Wu Y., Xu J. et al. Reactive Nitrogen Species Induced by Hyperglycemia Suppresses Akt Signaling and Triggers Apoptosis by Upregulating Phosphatase PTEN (Phosphatase and Tensin Homologue Deleted on Chromosome 10) in an LKB1-Dependent Manner. Circulation 2007; 116: 1585-95.


For citation:


Mardanov B.U., Mamedov M.N., Korneeva M.N., Oganov R.G. Features of the in-hospital course of myocardial infarction in patients with glucose metabolism disorders. Rational Pharmacotherapy in Cardiology. 2015;11(5):477-482. (In Russ.) https://doi.org/10.20996/1819-6446-2015-11-5-477-482

Views: 331


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)