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.

DESIGN

Descriptive study.

PLACE AND DURATION OF STUDY

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

PATIENTS AND 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).

CONCLUSION

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.