Outcome of Patients Presenting with ST Elevation Myocardial Infarction among Diabetics and Non-diabetics

Introduction: ST elevation myocardial infarction (STEMI) is a condition characterized by typical ischemic symptoms resulting from a total occlusion of a coronary artery. STEMI is specifically diagnosed on the electrocardiography. Diabetic patients reveal a more complicated anatomy of the coronary vessels in comparison to patients who are not diabetic. Furthermore, the diabetic patients more likely develop early post-infarction angina, stent thrombosis, and recurrent MI.

Materials and methods: This cohort study conducted at adult cardiology department in a tertiary care hospital, Karachi for Six months. From August, 29, 2017 to March, 1,2018. The patients were divided into two groups. Group-A were consisted of diabetic patients and Group-B were consisted of non-diabetic patients and their in-hospital outcome was monitored.

Results: 282 patients with 141 patients with diabetes and 141 non-diabetic patients were included. Mean age was 58.44±12.9 years in exposure group and 64.68±12.2 years in non-exposed group. In-hospital outcomes in diabetic and non-diabetic group was as followed; arrhythmias[ 64(78%) vs.50(60.9%);RR= 2.08]. recurrent angina [9(10.9%) vs.6(7.3%);RR=1.56]. cardiogenic shock [10(12.2%) vs. 5(6.1%); RR=2.14] , In-hospital mortality. [15(18.3%) vs. 7(8.5%); RR=2.39] and congestive heart failure [ 15(18.3%) vs. 8(9.8%); RR= 2.24].

Conclusion: Outcome of patients with diabetes presenting with acute myocardial infarction have a poor prognosis as having higher mortality and morbidity.