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Opšta medicina
2013, vol. 19, iss. 3-4, pp. 71-80
article language: Serbian
document type: Original Scientific Paper

Myocardial infarction in patients with diabetes mellitus type 2: Incidence, clinical and angiographic characteristics
Dom zdravlja, Varvarin

e-mail: dulemiljkovic@open.telekom.rs

Abstract

Introduction. Population studies have shown that diabetes mellitus is an independent risk factor for cardiovascular disease. Incidence of ischemic heart disease in patients with type 2 diabetes is estimated at 10% to 20%. Angiographic and autopsy studies have shown that incidence of multi vessel disease is higher and coronary artery stenosis is more severe in patients with diabetes. Objective. The aim of the study was to examine the incidence, clinical and angiographic characteristics of myocardial infarction in patients with type 2 diabetes mellitus. Method. The retrospective study included 1200 patients with type 2 diabetes mellitus, 506 (42.2%) men and 694 (57.8%) women. The control group consisted of 1246 consecutive patients without diabetes, 550 (44.1%) men and 696 (55.9%) women (p> 0.05). From both groups, we separated 90 patients with myocardial infarction, 50 patients with ischemic stroke and diabetes and 40 patients with acute myocardial infarction without diabetes who underwent heart catheterization with selective coronary angiography. Results. The average age of patients with diabetes was 64.9 ± 10.4 years, and of patients without diabetes 66.9 ± 13.0 years (p<0.001). Myocardial infarction had 115 (9.6%) patients in the group with diabetes and 50 (4.0%) in the control group without diabetes (p <0.01). Myocardial infarction had 70 (13.8%) patients from the group of 506 male patients with diabetes, and 45 (6.5%) from the group of 694 women with diabetes (p <0.01). In the control group of 550 patients, myocardial infarction was found in 39 (7.1%) male, and 11 (1.6%) female patients without diabetes (p <0.01). Incidence of myocardial infarction was significantly higher in patients with diabetes than in those without diabetes, both in male (13.8% vs. 7.1%, p<0.01) and in female population (6.5% vs. 1.6%, p <0.01). Anterior localization of myocardial infarction was found in 58 (50.4%) patients with diabetes and 22 (44.0%) without diabetes (p> 0.05), and inferior localization in 41 (35.7%) patients with diabetes and 22 (44.0%) without diabetes (p> 0.05). Three-vessel disease had 32/50 (64%) patients with diabetes and 13/40 (32.5%) without diabetes (p <0.01). Multi vessel disease was found in 43/50 (86.0 %) patients with diabetes and 24/40 (60.0%) patients without diabetes (p<0.01). Conclusion. Significantly higher incidence of myocardial infarction in patients with diabetes compared to those without diabetes suggests that diabetes mellitus is an important risk factor for development of myocardial infarction. Three-vessel disease, multiple coronary stenosis, and total occlusion of the coronary artery are significantly more frequent in patients with myocardial infarction and diabetes.

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References

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