Acute myocardial infarction in diabetics and non-diabetics

Four hundred and ninety one patients with acute myocardial infarction [AMI] were included in this study. The frequency of diabetes mellitus [DM] among them was 17%, being 25% in females and 14% in males [p < 0.004]. The immediate mortality rate [IMR] in diabetics was 35% compared to 20% in non-diabetics [p < 0.002]. The impact of DM occurred on both sexes but the main impact was on females above the age of 50. The mean age of diabetics was 59.7 [SD 8.6] years and of non-diabetics was 59.3 [SD 10.1] years. Smoking and hypercholesterolaemia were common among diabetics and non-diabetics. The frequency of hypertension was significantly higher in diabetics [p < 0.05] and was associated with significant increase of IMR in both groups [p < 0.01]. Cardiogenic shock, severe heart failure, hypotension and arrhythmias were the most serious complications of AMI in both groups. Heart failure was significantly more frequent in diabetics [p < 0.03] while cardiogenic shock, hypotension and arrhythmias occurred equally in both groups. We compared our findings with those of previous reports and the results were discussed

Myocardial infarction in young Iraqi patients: changes in trends of risk factors and complications over the past decade

Twenty one patients aged 40 years or under, with acute myocardial infarction admitted to the coronary care unit, over a period of 3 years, were studied and compared to 470 patients over 40 with acute infarction admitted to the unit over the same period. The young patients age ranged from 28-40 years with a mean of 37.5 [SD 3.4]. The male to. female ratio was 9.5:1 and the anterior to inferior infarction ratio was 2.5:1. The frequency of smoking declined with age. while that of hypercholesterolaemia, hypertension, angina, diabetes mellitus, heart failure and mortality rate increased. Comparing our young infarcted patients with similar patients who were admitted to the same unit one decade ago, it was noted that the frequency of smoking had increased by 27%, of hypercholesterolaemia by 58% and that of family history of coronary heart disease by 200%. Meanwhile, the frequency of hypertension declined by 33%. The increasing frequency of smoking and hypercholesterolaemia in patients with acute myocardial infarction, which reached levels comparable to the highest in the World, calls for urgent measures to campaign against smoking and to evaluate our diet to reduce hypercholesterolaemia