Abstract
Background: Patients with recent myocardial infarction have an increased incidence of impaired fasting glucose (IFG) and new-onset diabetes. There is a clear relationship between elevated fasting glucose during acute myocardial infarction and increased mortality and morbidity risk. Objective: To find out the impact of fasting glycaemia as a predictor of outcome of patients with acute myocardial infarction. Methods: A total of 102 patients with acute myocardial infarction of first attack were selected according to inclusion and exclusion criteria. Fifty-one patients with acute myocardial infarction having fasting hyperglycaemia were enrolled as case group and another 51 patients with acute myocardial infarctions having fasting euglycaemia were enrolled as control group. Results: Among the diabetic patients, acute left ventricular failure (ALVF) developed in 22 (68.8% ), arrhythmias in 5 (16.6%) and cardiovascular mortality in 8 (25.0% ) patients ; it was 7 (36.8%), 4 (21.1 %) and 4 (21.1 %) respectively in IFG patients; and 7 (13.7%) ,4 (7.8%) and 2 (3.9%) respectively in euglycaemia patients. Acute left ventricular failme and 30 days CV mortality significantly differed among the groups (p<0.001 and p=0.015 respectively). But no significant difference in arrhythmias (p=-0.284). Conclusions: The patients of impaired fasting glucose (IFG) and diabetes mellitus both were predictor for in hospital heart failure (ALVF) and 30-day cardiovascular mortality as compared to euglycaemia.
Highlights
Diabetes is an established risk factor for cardiovascular disease, and the risk of cardiovascular disease increases with worsening hyperglycaemia .r'2 Furthernore, coronary artery disease is the most common cause of death in patients with diabetes.[3]
In patients who have had recent myocardial infarction, the lack of insulin associated with hyperglycaemia may lead to a decrease of glycolytic substrate for cardiac muscle and excessive free fatty acids
IBSMMU J 20] s ; 6 (2) : t 35-1401 increased oxygen cost, lead to pump failure, and promote arrhyhmias Several studies have documented a clear relationship between elevated fasting glucose during acute myocardial infarction and increased mortality risk .e-12 UnHke the random glucose level on admission, impaired fasting glucose (IFG) may be a better reflection of abnormalities in underlying glucose metabolism, and may be a better predictor of both short-tefin and long- term outcomes
Summary
Diabetes is an established risk factor for cardiovascular disease, and the risk of cardiovascular disease increases with worsening hyperglycaemia .r'2 Furthernore, coronary artery disease is the most common cause of death in patients with diabetes.[3]. In patients who have had recent myocardial infarction, the lack of insulin associated with hyperglycaemia may lead to a decrease of glycolytic substrate for cardiac muscle and excessive free fatty acids .7 These changes may reduce myocardial contractility at IBSMMU J 20] s ; 6 (2) : t 35-1401 increased oxygen cost, lead to pump failure, and promote arrhyhmias Several studies have documented a clear relationship between elevated fasting glucose during acute myocardial infarction and increased mortality risk .e-12 UnHke the random glucose level on admission, IFG may be a better reflection of abnormalities in underlying glucose metabolism, and may be a better predictor of both short-tefin and long- term outcomes. Conclusions: The patients of impaired fasting glucose (IFG) and diabetes mellitus both were predictor for in hospital heart failure (ALVF)
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