Clinical and Angiographic Profile of Prediabetic Patients with Acute ST Elevation Myocardial Infarction

Abstract

Background: Clinical trials had demonstrated that acute ST segment elevated myocardial infarction (STEMI) with an abnormal glucose tolerance was risk factor for future cardiovascular events. This study was aimed to analyze the various clinical outcomes, coronary angiographic results and incidence of major adverse cardiovascular event (MACE) in prediabetic patients presented with STEMI in a tertiary care centre. Methods: Prediabetic patients who were presented with STEMI in the department of Cardiology included in the study. Age and sex matched non prediabetic patients with STEMI were selected as the control group. Demographic variables, clinical presentations, findings of coronary angiogram, electrocardiogram (ECG) and 2D echo, morbidity and cardiac mortality were collected and subjected to statistical analysis. Results: Total 70 patients (35 prediabetic and 35 non prediabetic as control) were included in this retrospective study. The major findings such as Killip class III and IV (clinical presentations); Bradyarrythmia (ECG manifestations); moderate and severe left ventricular dysfunction (2D Echo findings); double and triple vessel disease, right coronary artery, left circumflex artery, use of long stent (angiographic findings), MACE and cardiac mortality were found to be more in prediabetic patients than the non prediabetic control group. Conclusion: Prediabetic group had higher Killip class, more multivessel disease, higher MACE and cardiovascular mortality as compared to non prediabetic group, which emphasizes the need for early diagnosis of prediabetes.