2012, Number 2
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Rev Cuba Endoc 2012; 23 (2)
Situation of the acute myocardial infarction in persons with diabetes mellitus in Granma province
Valdés RER, Rivera CM, Bencosme RN
Language: Spanish
References: 44
Page: 128-138
PDF size: 69.69 Kb.
ABSTRACT
Background: diabetes mellitus is a risk factor for acute myocardial infarction and additionally, it seems to grant per se a prognosis of severity for the patients suffering this disease.
Objective: to evaluate the situation of the acute myocardial infarct in people with diabetes mellitus living in Granma province.
Methods: a cross-sectional descriptive study of 159 patients, who were admitted to the coronary intensive care unit of "Carlos Manuel de Céspedes" hospital in Bayamo, Granma and diagnosed with acute myocardial infarction in the period of January 2010 to June 2011. Out of these patients, 39 had diabetes mellitus and 120 were not affected by the disease. Demographic, clinical and metabolic data were taken from the medical histories.
Results: the percentage of extensive infarction without precordial pain in diabetes mellitus cases was higher than in non-diabetics, but it was not statistically significant (p= 0.3283 and p= 0.1066 respectively). The diabetic patients were 2.8 times more likely to suffer electrical complications that those non-diabetics (p= 0.0121). No significant association between mechanical complications of the acute myocardial infarction and diabetes mellitus was found. The number of deaths was significantly higher in cases with diabetes mellitus than in non-diabetic cases (p= 0.0214). The glycemic levels on admission were significantly higher in complicated and in dead cases, both diabetics and non-diabetics.
Conclusions: the acute myocardial infarctions in the diabetic patients of our province are often extensive and occur without precordial pain, with electrical complications and associated with high mortality rates. Hyperglycemia on admission is related to increased mortality and morbidity from acute myocardial infarction.
REFERENCES
Dirks JH, Robinson SW, Alderman M, Couser WG, Grundy SM, Smith SC, et al. Meeting report on the Bellagio Conference "Prevention of vascular diseases in the emerging world: an approach to global health equity". Kidney Int. 2006;70:1397-402.
Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta: Department of Health and Human Services, Centers for Disease Control and Prevention; 2011.
Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Heart disease and stroke statistics-2010 update: a report from the american heart association. Circulation. 2010;121:e46-e215.
American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2010;33:S11-61.
Kosiborod M, Inzucchi S, Krumholz H, Masoudi F, Goyal A, Xiao L, et al. Glucose normalization and outcomes in patients with acute myocardial infarction. Arch Intern Med. 2009;169(5):438-46.
Gil M, Martí H, Elosúa R, Grau M. Análisis de la tendencia en la letalidad, incidencia y mortalidad por infarto de miocardio en Girona entre 1990 y 1999. Rev Esp Cardiol. 2007;60(4):349-56.
Cuba. Minsap. Dirección Nacional de Registros médicos y estadísticas de salud. Anuario estadístico de salud; 2010.
Minsap. Dirección provincial de higiene y epidemiología. Informe anual del departamento de enfermedades crónicas no trasmisibles; 2006.
Minsap. Dirección provincial de higiene y epidemiología. Informe anual del departamento de enfermedades crónicas no trasmisibles; 2009.
LLanio Navarro R, Perdomo González G, Arús Soler E, Fernández Sacasas A, Fernández Sacasas JA. Propedéutica clínica y semiología médica. La Habana: Editorial Ciencias Médicas; 2005. p. 626-7.
WHO. Definition and classification of diabetes mellitus and complications. Report of WHO consultation. Part 1: Diagnosis and classification of Diabetes mellitus. World Health Organization. Géneva: Department of Noncommunicable Desease Surveillance; 1999.
Trinder P. Determination of glucose in blood using glucose oxidase with on alternative oxigen acceptor. Clin Biochem. 1996;13(2):24-7.
American Diabetes Association. Standards of Medical Care in Diabetes-2009. Diabetes Care. 2009;32(suppl 1):S13-61.
Buse JB, Ginsberg HN, Bakris GL, Clark NG, Costa F, Eckel R, et al. Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation. 2007;115:114-26.
Laakso M. Cardiovascular disease in type 2 diabetes from population to man to mechanisms: the Kelly West Award Lecture 2008. Diabetes Care. 2010;33:442-9.
Yamagishi S, Nakamura K, Takeuchi M, Imaizumi T. Molecular mechanism for accelerated atherosclerosis in diabetes and its potential therapeutic intervention. Int J Clin Pharmacol Res. 2004;24:129-34.
Cooper-Dehoff RM, Gong Y, Handberg EM, Bavry AA, Denardo SJ, Bakris GL, et al. Tight blood pressure control and cardiovascular outcomes among hypertensive patients with diabetes and coronary artery disease. JAMA. 2010;304:61-8.
Bansilal S, Farkouh ME, Fuster V. Role of insulin resistance and hyperglycemia in the development of atherosclerosis. Am J Cardiol. 2007;99:6B-14B.
López Ramírez M, Quirantes Moreno AJ, López Ramírez D. Caracterización del infarto agudo del miocardio en la clínica popular "Simón Bolívar". Rev Cubana Med Gen Integr. 2009;25(4):151-9.
Castillo Hernández E, Vázquez Lazo C, Quintana Ramire M. Comportamiento clínico epidemiológico de la cardiopatía isquémica en la unidad de cuidados intensivos polivalente. Rev Cubana Enfermer [serie en Internet]. 2008 Mar [citado 26 de noviembre de 2011];24(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-03192008000100003&lng=es
García Calzado MC. Diabetes mellitus tipo 2 y riesgo cardiovascular. Un modelo de arteriosclerosis precoz y acelerada. Clin Invest Arterioscl. 2007;19(3):143-6.
Burchfiel CM, Reed DM, Marcus EB, Strong JP, Hayashi T. Association of diabetes mellitus with coronary atherosclerosis and myocardial lesions: an autopsy study from the Honolulu Heart Program. Am J Epidemiol. 1993;137:1328-40.
Stein PK, Bosner MS, Kleiger RE, Conger BM. Heart rate variability: a measure of cardiac autonomic tone. Am Heart J. 1994;127:1376-81.
Sánchez-Arrendondo C. Consideraciones anestésicas en el paciente diabético. Fármacos. 2003;16(2):12-31.
Pacheco GL, Almeida de OW, Aurora AS. A diferenciação da dor do infarto agudo do miocárdio entre pacientes diabéticos e não-diabéticos. Rev Latino-Am Enfermagem [serie en Internet]. 2003 [citado 24 de noviembre de 2011];11(6) Disponible en: http://dx.doi.org/10.1590/S0104-11692003000600004
Van Heerebeek L, Hamdani N, Handoko ML. Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation end products, and myocyte resting tension. Circulation. 2008;117:43-51.
Boudina S, Abel ED. Diabetic cardiomyopathy, causes and effects. Rev Endocr Metab Disord. 2010;11:31-9.
Stone PH, Muller JE, Hartwell T. The effect of diabetes mellitus on prognosis and serial left ventricular function after acute myocardial infarction: contribution of both coronary disease and diastolic left ventricular dysfunction to the adverse prognosis. J Am Coll Cardiol. 1989;14:49-57.
Lorenzo Velázquez BM, Peinado Moreno M, Betancourt Loaces E, Remis Pérez CJ, Torres García C. Morbilidad por IMA en pacientes mayores de 60 años. Unidad de cuidados intensivos coronarios. Año 2004. Rev Ciencias Médicas. 2005 Jun;9(2):12-21.
Vega G, Martínez S, Jiménez PA, Navarro A, Bernad F. Efecto de los factores de riesgo cardiovascular sobre la morbimortalidad a largo plazo después de un infarto agudo de miocardio. Rev Esp Cardiol. 2007;60(7):703-13.
Fonseca Muñoz JC, Álvarez Aliaga A, Frómeta Guerra A, Fonseca Muñoz TA. Factores predisponentes para la muerte por infarto agudo del miocardio. Multimed [serie en Internet]. 2010 [citado 26 de noviembre de 2011];14(2). Disponible en: http://www.multimedgrm.sld.cu/articulos/2010/v14-2/8.html
Bueno H, Bardají A, Fernández-Ortiz A, Marrugat J, Martí H, Heras M. Descripción del Estado de los Síndromes Coronarios Agudos en un Registro Temporal Español. Estudio DESCARTES. Rev Esp Cardiol. 2005;58:242-50.
Cabrera Rego JO, Palacio Pérez H. Factores asociados a mortalidad intrahospitalaria en el infarto agudo del miocardio con supradesnivel del ST. Rev Cubana Invest Biomed [serie en Internet]. 2008 Mar [citado 26 de noviembre de 2011];27(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-03002008000100005&lng=es.
Zeller M, Steg PG, Ravisy J, Lorgis L, Laurent Y, Sicard P, et al. Relation between body-mass-index, waist circumference and death after acute myocardial infarction. Circulation. 2008;118:482-90.
Webster KA. Stress hyperglycemia and enhanced sensitivity to myocardial infarction. Curr Hypertens Rep. 2008;10:78-84.
Marfella R, Di FC, Esposito K, Nappo F, Piegari E, Cuzzocrea S, et al. Absence of inducible nitric oxide synthase reduces myocardial damage during ischemia reperfusion in streptozotocin-induced hyperglycemic mice. Diabetes. 2004;53:454-62.
Ishihara M, Inoue I, Kawagoe T, Shimatani Y, Kurisu S, Nishioka K, et al. Effect of acute hyperglycemia on the ischemic preconditioning effect of prodromal angina pectoris in patients with a fi rst anterior wall acute myocardial infarction. Am J Cardiol. 2003;92:288-91.
Tuo QH, Zeng H, Stinnett A, Yu H, Aschner JL, Liao DF, et al. Critical role of angiopoietins/Tie-2 in hyperglycemic exacerbation of myocardial infarction and impaired angiogenesis. Am J Physiol Heart Circ Physiol. 2008;294:H2547-57.
Venkatachalam K, Mummidi S, Cortez DM, Prabhu SD, Valente AJ, Chandrasekar B. Resveratrol inhibits high glucose-induced PI3K/Akt/ERK-dependent interleu-kin-17 expression in primary mouse cardiac fibroblasts. Am J Physiol Heart Circ Physiol. 2008;294:H2078-87.
Ray KK, Seshasai SR, Wijesuriya S. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. Lancet. 2009;373:1765-72.
Pinto DS, Kirtane AJ, Pride YB, Murphy SA, Sabatine MS, Cannon CP, et al. CLARITY-TIMI 28 Investigators. Association of blood glucose with angiographic and clinical outcomes among patients with ST-segment elevation myocardial infarction (from the CLARITY-TIMI- 28 study). Am J Cardiol. 2008;101:303-7.
Kosiborod M, Inzucchi S, Krumholz H, Masoudi F, Goyal A, Xiao L, et al. Glucose normalization and outcomes in patients with acute myocardial infarction. Arch Intern Med. 2009;169(5):438-46.
Greig D, Corbalán R, Castro P, Campos P, Iamich R, Yovaniniz P et al. Implicancias de la glicemia de ingreso en la mortalidad intrahospitalaria y alejada según el método de reperfusión en pacientes con infarto agudo del miocardio y supradesnivel del segmento ST. Rev Méd Chile. 2010 Sep;138(9):1109-16.
Nau G, Albertal M, Thierer J, Botto F, Cura F, Padilla L, et al. La glucemia en ayunas como predictor de mortalidad intrahospitalaria en pacientes con infarto agudo de miocardio sometidos a angioplastia primaria. Rev Argent Cardiol. 2009 Oct;77(5):361-6.