[Chronic miocardial infarction among patients with diabetes mellitus or impaired glucose tolerance].
Chronic myocardial infarction represents one of the most important problems of actual clinical medicine because their incidence is growing especially at young adults (< 45 years) and their mortality with no treatment is high in first month after acute myocardial infarction (50%). When cardiovascular disease is associated with diabetes mellitus, evolution of patients is more serious.


OBJECTIVE
To compare the disease evolution for two groups of patients--one with patients who have purely chronic myocardial infarction and other with patients who have chronic myocardial infarction associated with glycoregulation disturbances (diabetes mellitus, impaired glucose tolerance or impaired fasting glucose).


METHODS
The study group included 205 patients with chronic myocardial infarction; the study was a retrospective analysis of the clinical and biochemical parameters of patients.


RESULTS
The patient age was between 37-89 years (the middle age was 65 years) and the predominant environment was urban. All of the patients have chronic myocardial infarction and 60% of them have associated glycoregulation disturbance. The majority of hospitalised patient was symptomatic and the major symptoms where chest pain and dyspnoea. Most patients had abdominal obesity associated with hypertension and tachycardia. The most frequent component of metabolic syndrome was hypertension. More patients had abnormal value of glycaemia, the expression of an inefficient control of the diabetic disease. High level of the serum cholesterol and triglycerides was found more frequently. Hypercholesterolemia was a predominant expression of dyslipidemia in discordance with literature dates for diabetic patient. A different degree of renal failure was found, frequently in patients with glycoregulation disturbances. The electrocardiograms revealed that the majority of patients have a complete (transmural) myocardial infarction and the most frequently localisation was the previous one. The clinical manifestation-breathing and ecocardiographical aspects (law value of EjF and abnormal parietal kinetic) expression of the cardiac failure was found in 46% patients more frequently in diabetic disease. The complication of myocardial infarction -post infarction angina, ventricular aneurism, and arrhythmia -appears more frequently among patient with glycoreglation disturbance. The other vascular territories affected by ATS where cerebral arteries and peripheral arteries.


CONCLUSIONS
This study confirms the unfavourable evolution of myocardial infarction in diabetic patient.
Mihalcea
Cecilia
C
Facultatea de Medicină, Clinica a VI-a Medicala, Universitatea de Medicina si Farmacie "Gr.T.Popa" Iaşi.
Pandele
G I
GI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain; D002784:Cholesterol / Q000097:blood; D002908:Chronic Disease; D048909:Diabetes Complications / Q000097:blood / Q000175:diagnosis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D004562:Electrocardiography; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D006973:Hypertension / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D056128:Obesity, Abdominal / Q000150:complications; D051437:Renal Insufficiency / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013610:Tachycardia / Q000209:etiology; D014280:Triglycerides / Q000097:blood
D015415:Biomarkers; D014280:Triglycerides; D002784:Cholesterol