Diabetes Myocardial Infarction Research Articles

Myocardial Infarction in Diabetics

The hospital mortality of acute myocardial infarction amongst 285 known diabetics treated in the last decade was 39.7 per cent at one month and had increased to 51 per cent at 12 months. Treatment in a coronary care unit during the acute stage had little effect on the mortality amongst patients on insulin, but was beneficial for patients whose diabetes had been controlled by oral hypoglycaemic drugs. Female patients on oral hypoglycaemic drugs had the highest mortality. When considering age, duration of diabetes and presence of retinopathy, acute myocardial infarction in diabetics controlled on oral therapy appeared to have a worse outcome than in patients on insulin. Independently of whether patients were on insulin or on oral hypoglycaemic drugs 12 months after the acute episode, only about half of them were still alive.

Myocardial infarction in patients with diabetes mellitus

To date, there is no consensus on the relationship between myocardial infarction and diabetes mellitus. Some authors [18, 19, 20, 24, 29, 33 et al.] note a more frequent occurrence of myocardial infarction in diabetes mellitus, others [4, 34, etc.] did not find the effect of diabetes mellitus on the frequency of myocardial infarction and mortality in it. A number of authors [6, 7, 11, 13, 16, 24 et al .] indicates a more severe course of diabetes mellitus on the background of myocardial infarction and myocardial infarction on the background of diabetes mellitus, high mortality, shorter life expectancy after myocardial infarctions, repeated myocardial infarctions, frequent ruptures of the heart muscle, severe collapses. Joslin et al., Heinsen believe that in diabetes mellitus, as a rule, myocardial infarctions are pain-free, while others do not find a difference in the symptoms of myocardial infarctions in diabetes mellitus. There is no unanimity on the issue of thrombosis in diabetes mellitus. So, Fearuley, Chakraborti found in diabetes mellitus a decrease in fibrinolytic activity and an increased tendency of the blood to thrombosis. According to Thomas, Lee, Rabin, Coodale et al., the frequency of thromboembolic complications and lysis time in patients with diabetes mellitus and myocardial infarction do not differ from those in patients with a heart attack without diabetes.

New quantitative vectorcardiographic criteria for the detection of unsuspected myocardial infarction in diabetics

New quantitative vectorcardiographic criteria for the detection of unsuspected myocardial infarction in diabetics

Chemico-anatomic studies of arteriosclerosis and thrombosis in diabetics: II. Fatty acids of adipose tissue and plasma lipids in several groups of North American diabetics and nondiabetics

It has been well established by both clinical and autopsy studies that myocardial infarction is much more common in North American white diabetics compared with nondiabetics. In this study the possible interrelationships between myocardial infarcts, diabetes and adipose tissue fatty acids and plasma lipids were studied by comparing diabetics unselected as to the presence or absence of complications with age- and sex-matched nondiabetics. Adipose tissue fatty acids were measured because of the suggested abnormal release of fatty acids from tissue stores in the diabetic. Only palmitic acid of six adipose tissue fatty acids compared in diabetics and nondiabetics was found to be significantly different, and this only in female diabetics, compared to female nondiabetics. The biologic significance of this finding is questionable. The finding of similar linoleic acid values in North American diabetics and nondiabetics suggests that there is no deficiency of linoleic acid in the diabetic adipose tissue stores contributing to the greater incidence of myocardial infarction in this group. Among plasma lipids, no difference was found in comparing plasma cholesterol levels. However, triglycerides (in both male and female diabetics) and lipid phosphorus (in female diabetics) were found to be elevated when compared to levels in nondiabetics. The elevated serum triglycerides in the diabetic group in this study is in keeping with the serum triglyceride levels found in other groups of diabetics who have strikingly different frequencies of myocardial infarction. North American white, North American Negro, and East African diabetics, with a high, intermediate, and low frequency of myocardial infarction respectively showed high, intermediate, and low levels of serum triglyceride. Although the evidence is far from complete, there is at least some reason to believe that plasma lipids are involved in the clotting mechanism. It is possible that the elevated plasma lipids found in this group of diabetics may explain the greater susceptibility to coronary artery thrombosis and myocardial infarction in diabetes.