ЛЕТАЛЬНОСТЬ В ТЕЧЕНИЕ ГОДА У БОЛЬНЫХ САХАРНЫМ ДИАБЕТОМ II ТИПА ПОСЛЕ ОСТРОГО ПЕРЕДНЕГО ИНФАРКТА МИОКАРДА С ЗУБЦОМ Q

Abstract

Abstract. Introduction. Type II diabetes is now a global epidemic, its prevalence has significantly increased globally. Myocardial infarction is the primary cause of death in type II diabetes patients. Aim. The aim is to study one-year mortality in patients with diabetes mellitus type II after acute anterior myocardial infarction with Q-wave, receiving one of the sulfonylureas. Material and methods. Participated in the study 246 patients with type II diabetes and acute anterior Q-wave myocardial infarction receiving sulfonylureas. The patients were divided into 2 groups: control group (n=156) and the main group (n=90). All patients received standard examination and treatment of acute myocardial infarction. Patients from the main group were given a second breakfast 2 hours after taking sulfonylurea to prevent hypoglycemic reactions. Results and discussion. One year after acute anterior Q-wave myocardial infarction in patients with type II diabetes mellitus mortality in the control group was 26,2% (n=41), and in the main group – 1,1% (n=1). The mortality rate in the control group was significantly higher, which was statistically significant (p<0,05). The main cause of mortality in patients in control was a severe degree of chronic heart failure (31,7%, n=13), in second place are episodes of heart arrhythmia (24,3%, n=10), and repeated myocardial infarction (24,3%, n=10), and the rarest cause was pulmonary embolism (3,7%, n=3). The greatest mortality in the control group was observed in the glibenclamide subgroup (39%, n=16), then in the glimepiride subgroup (34,1%, n=14) and gliclazide (26,9%, n=11). In the control group, hypoglycemia was higher (49,3%, n=78) than in the main group (15,5%, n=14), which was statistically significant (p<0,05). The incidence of hypoglycemia in the glibenclamide subgroup was statistically higher (p<0,05) than in the gliclazide and glimepiride subgroups. Conclusion. Mortality in patients with type II diabetes within a year after an acute anterior myocardial infarction with a Q-wave in a group of patients where the risk of receiving repeated hypoglycemic reactions is minimized is significantly less.