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ORIGINAL ARTICLE
Year : 2018  |  Volume : 35  |  Issue : 1  |  Page : 60-66

Clinical outcome of patients with diabetes mellitus and acute myocardial infarction treated with primary angioplasty


Department of Cardiology, Faculty of Medicine, Benha University, Banha, Egypt

Correspondence Address:
Kerolus K Gad
16th Diaa Street Haram, Giza
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-208X.226419

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Purpose The purpose of the present study was to examine the influence of diabetes mellitus (DM) on the clinical outcome in patients with acute myocardial infarction (MI) treated with primary coronary stenting within 24 h of the onset of symptoms. Methods We enrolled 100 patients (50 diabetics and 50 nondiabetics) admitted to the coronary care units of Benha University hospitals and National Heart Institute from January 2015 to December 2015 with acute MI treated with primary coronary stenting within 24 h of the onset of symptoms. Clinical outcome was observed in every patient for major adverse cardiac events and hospital stay. Echocardiography was also performed before the patient’s discharge from the hospital. Patients were followed up at 3 months for the occurrence of major adverse cardiac events. Results The diabetic patients showed higher incidence of hypertension (P=0.003), renal impairment (P=0.045) and dyslipidemia (P=0.05) and also higher incidence of heart failure (P=0.013) during admission and higher mean serum creatinine kinase MB mass assay levels (P=0.005). There were no statistically significant differences in other variables. Procedural success was similar in the two groups. With regard to in-hospital clinical course, diabetic patients were more likely to have early post-MI heart failure (P=0.013), target vessel revascularization (P=0.037) and longer hospital stay (P=0.019). At 3 months, diabetic patients were significantly more likely to experience revascularization (P=0.045) and were more likely to be rehospitalized for acute coronary syndrome and decompensated heart failure (P=0.037); however, there was no significant difference in mortality (P=0.307). Conclusion Compared with nondiabetics, diabetic patients are more likely to have early post-MI heart failure, target vessel revascularization, and longer hospital stay. Moreover, diabetic patients are significantly more likely to experience revascularization and are more likely to be rehospitalized for acute coronary syndrome or decompensated heart failure.


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