RESUMO
Ischemic heart disease is estimated to be the most important cause of mortality by the end of 2020 world wide despite sufficient improvement in health care. It has several modifiable and few non modifiable prognostic variables. Therefore, we analyzed the data of all patients admitted for the first time for acute myocardial infarction (MI) and evaluated the long term modifiable prognostic variables retrospectively. We did not find any difference in the age, blood pressure, hematological and several biochemical parameters between patients who survived and those who expired in 4 years of follow up. Our study revealed that in the expired group patients, the mean admission heart rate, ejection fraction, serum urea and creatinine levels were higher and bicarbonate level was lower compared to survived group patients at the first attack of MI. Also, despite the less incidence of myocardial infarction in females, the percentage of cardiac death was higher in female MI patients. We suggest from our retrospective analysis that MI patients with higher heart rate, altered renal function and metabolic acidosis should be rigorously followed up and special counseling should be provided to old age female patients for better prognosis and survival.
RESUMO
Male gender and fasting sugar level at pre diabetic range are two of the recognized risk factors associated with coronary artery disease. Recently it was found that although males are at increased incidence of myocardial infarction (MI), the severity of disease is same for both genders among pre-diabetic myocardial infarction cases. In this study, we have retrospectively analyzed various biochemical and physiological parameters and cardiac markers of patients admitted for the first instance of myocardial infarction. We found an evidence of impairment in blood pressure homeostasis in female patients which could be one of the factors responsible for the equal degree of severity in myocardial infarction among females compared to males, despite lower incidence of MI in them.
RESUMO
Diabetes mellitus (DM) is one of the important risk factors for cardiac diseases. Type 2 DM is the commonest form of diabetes, which is characterized by insulin resistance. Insulin resistance can be preceded by long term abnormality in glucose homeostasis which is called pre-diabetes. Recently, pre-diabetes has been suggested to have an increased risk of cardiovascular disease. Considering that India has been declared as a diabetic capital of the world it deemed pertinent to assess the exact load of pre diabetics and non diabetics landing in myocardial infarction. We analyzed retrospectively the data of all patients admitted for the first time for acute myocardial infarction (MI) and evaluated the load of non diabetics, pre diabetics and diabetics among them. We found difference in the severity of diseases and degree of biochemical alterations among the three groups suggesting that abnormal glucose homeostasis has no role on the severity of MI. No previous studies have investigated the difference in male and female MI patients with respect to their glucose metabolism and its impact on the severity of the disease. Our study reveals that males even with normal glucose level are at increased risk to develop MI. Males on the other hand have increased risk for MI when compared to females with normal glucose homeostasis.