Retrospective analysis of patients with diabetes mellitus type 2 and acute myocardial infarction

Background. Acute myocardial infarction (AMI) in patients with type 2 diabetes mellitus (T2DM) is characterized by a severe course and unfavorable clinical outcomes. Accumulating information, which characterize the features of the development of AMI depending on the degree of carbohydrate metabolism disorders (CMD).

Aim. To conduct a retrospective analysis of medical records with an assessment of the clinical profiles of the patients with T2DM and AMI.

Materials and methods. A retrospective analysis of medical records of patients in the acute period of myocardial infarction over a five-year period was carried out. The exclusion criteria were: unstable or stable angina pectoris. The average values and standard deviations (M±SD) were calculated. Comparison of quantitative variables between groups was carried out using the Student's t-test. Absolute (n) and relative (%) values were calculated to describe qualitative data. The value p<0.05 was used as the level of statistical significance.

Results. The total number of medical records is 7618, of them with AMI – 2337 cards, of which 1114 (48%) patients with T2DM, type 1 diabetes mellitus, impaired glucose tolerance/impaired fasting glycemia (IGT/IFG) and AMI, as well as 1223 (52%) patients with AMI without CMD. Among patients with AMI, patients with T2DM and AMI accounted for 23%. Gender differences with female dominance were registered in the group of T2DM and AMI (63%), men dominated among patients with AMI without CMD. In the groups of T2DM and AMI, IGT/IFG and AMI, AMI without CMD, women were older than men (p<0.05%). In patients with T2DM and AMI, compared with patients with AMI without CMD, repeated AMI and high mortality are more often registered. The presence of diabetes was associated with a higher incidence of concomitant diseases and the presence of severe complications of the disease.

Conclusion. Clinical features of AMI in patients with T2DM are represented by gender-age parameters, characteristics of concomitant pathology and the nature of complications of acute ischemia, the frequency of repeated AMI with an increased risk of adverse outcomes.