FEATURES OF ACUTE MYOCARDIAL-INFARCTION I N DIABETIC-PATIENTS

We analyzed retrospectively the clinical course and prognosis of 565 c onsecutive patients with acute myocardial infarction (AMI), 117 of the m with a previous history of diabetes mellitus. Male/female ration was 7.912. 1 in non diabetics and 7.013. 0 in diabetics (p < 0. 03). Inci dence of hypertension and hyperlipidemia was higher in diabetic patien ts as well a history of congestive heart failure (1 3.7% vs 6.5 in non diabetics p < 0. 01). The type and location of AMI did not differ amo ng groups, however the incidence of congestive heart failure Killip cl ass III-IV was higher in diabetic patients (31.6 vs 21.2%). Peak CPK v alues were lower in diabetics (1.270 +/- 1.179 vs 1. 648 +/- 1.377 U/I p < 0. 01). Cardiac mortality was higher one month and one year after AMI in diabetics (1 7 1 vs 13.6% and 21.4 vs 1 7. 8% respectively, p < 0. 01). Univariate and multivariate analysis identified new bundle b ranch block, heart failure and advanced age as independent predictors of mortality in both groups of patients It is concluded that the worst prognosis of diabetic patients with AMI may be related to a previousl y depressed ventricular function and that appropriate metabolic contro l and treatment of associated risk factors, could improve the prognosi s of diabetics patients with AMI