Uncontrolled Glucose Levels: A Risk Factor in Diabetic Patients Presenting with Acute ST Elevation Myocardial Infarction (STEMI)
Abstract Introduction: Acute myocardial infarction (MI) is a major cause of morbidity and mortality in diabetic patients. Factors unique to diabetes contribute in a higher incidence of MI due to an increase in atherosclerotic plaque formation and thrombosis. Although diabetic patients have a higher risk for developing ischemic heart disease, the effect of diabetes mellitus (DM) on the prognosis of patients with acute MI after reperfusion therapy remains controversial. Objectives: The aim of this study was to assess and compare the prognosis, complications, systolic and diastolic functions of controlled vs. uncontrolled diabetics. Materials and methods: A retrospective study was performed on 98 patients presenting with acute STEMI. 37 patients (37.8%) were found to have DM Type 2. Diabetic patients had their glucose levels measured and were further divided into 2 groups, controlled diabetics with glucose values of ≤125 mg/dl for fasting blood sugar (FBS) or postprandial with ≤140 mg/dl and uncontrolled diabetics with ≥140 mg/dl for FBS or postprandial ≥200 mg/dl. Results: Out of the 37 diabetic patients, males were 67.6% while females were 32.4% with a mean age of 59 ± 11. Hypertension was present in uncontrolled and controlled diabetics with 80.8% and 54.5% respectively. 3.8% of the uncontrolled diabetics presented with ventricular tachyarrhythmia. Tricoronary artery involvement was found in 34.6% of the uncontrolled patients and in 18% of the controlled patients. Post MI reperfusion management complications were present in uncontrolled and controlled diabetic patients with 11.5% and 9.1% respectively. Systolic dysfunction was present in uncontrolled and controlled groups in 84.6% vs. 72.7% while diastolic dysfunction was present in 73.1% vs. 27.3% respectively. Mortality rate was 3.8% in diabetic patients with uncontrolled glucose levels. Conclusions: Uncontrolled glucose levels in diabetic patients were significantly correlated with higher rates of tachyarrhythmia, tricoronary artery involvement, hypertension, post MI reperfusion management complications, mortality rates, systolic and diastolic dysfunctions.
AbdulRahman Samy Ismaiel
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