In-hospital outcome of acute myocardial infarction (st segment elevation type) in diabetics and non-diabetics.
OBJECTIVE
To evaluate the in-hospital mortality and complications of acute myocardial infarction in diabetic and non-diabetic patients.


METHODS
Descriptive study.


METHODS
Coronary Care Unit and Cardiology Ward of Nishtar Hospital, Multan from 1st October 2002 till 15th May 2003.


METHODS
Four hundred and forty-eight (448) consecutive patients who fulfilled the inclusion criteria were studied while they were admitted to the hospital. Patients were divided into two groups of diabetics and non-diabetics depending on the presence of diabetes mellitus. In-hospital mortality and complications were compared between the two groups by Chi-square method.


RESULTS
Diabetic patients presented in more advanced Killip class as 32(26.7%) patients presented in Killip class II, 13(10.8%) patients presented in Killip class III and 6(5%) patients presented in Killip class IV. In the non-diabetic group, 68(20.7%), 24(7.3%) and 11(3.4%) patients presented in these Killip classes respectively (p<0.042). The total in-hospital mortality was 17%. Mortality was 28(23.3%) in diabetics and 48(14.6%) in non-diabetics (p<0.03). In-hospital mortality was almost double in diabetics as compared to non-diabetics. Mechanical complications were observed in 42(35%) patients in diabetic group and 80(24.4%) patients in non-diabetic group. Left ventricular failure was the most commonly observed mechanical complication. Electrical complications were observed in 84(70%) diabetic and 162(49.4%) non-diabetic patients (p<0.205).


CONCLUSIONS
In patients with acute myocardial infarction, presence of diabetes mellitus was associated with worse in-hospital outcome leading to increased mortality and complications as compared to non-diabetic patients.
Abid
Abdul Rehman
AR
Department of Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan. drabdulrehman@hotmail.com
Mallick
Nadeem Hayat
NH
Shahbaz
Ahmad
A
Tarin
Siraj Ahmed Munir
SA
D000328:Adult; D048909:Diabetes Complications / Q000150:complications*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D016896:Treatment Outcome