Study on ST- segment elevation acute myocardial infarction [STEMI] in diabetic and non- diabetic patients

ABSTRACT

To compare some epidemiological and other parameters between diabetic and non-diabetic subjects admitted with STEMI. Two hundred and forty patients were included in the study, 76 [32%] were diabetic, and 164 [68%] were non-diabetic. Among diabetic patients 11/76 were newly diagnosed. The male to female ratio in diabetic was 1.51 [P=0.02], while in non-diabetic it was 5.81 [P=0.001]. At age 55-64 years, STEMI was observed in higher [P=0.001] percentage of diabetic than non-diabetic patients. 82% of the patients reached the hospital within six hours of chest pain. 52.5% of patients were smokers, 40% had long-standing dyslipidaemia, 32.5% were obese, 32% were diabetic and 29% had hypertension. Significant [P = 0.000003] percentage of non-diabetic patients were smokers, while of diabetic patients [P = 0.03] were obese. Dyslipidaemia was the stronger risk factor among diabetics, while it ranked number three in non-diabetic patients. The lateral infarction was more common [P =0.01] in diabetics. Anterior and inferior infarction was more common than inferior + right ventricular and lateral infarction in both diabetic and non-diabetic patients. Trop-T level was low in 46% and high in 54% of diabetic patients, while it was negative in 10%, detectable in 3%, low in 39% and high in 48% of non-diabetic patients. The mean level of various enzymes did not show statistical difference between diabetic and non-diabetics including CK [2008 +/- 785; 1045 +/- 356], CK-MB [211 +/- 75; 157 +/- 23] and Trop-T [1.85 +/- 0.28; 1.77 +/- 0.21]. Irrespective of diabetic status, the mean stay of patients in the hospital was 5.99 +/- 1.04 days. Smoking, dyslipidaemia and obesity are strong risk factor for STEMI. Infarction of anterior site is more frequent. Among diabetics, chances of STEMI are almost equal in male and female, while among non-diabetics it is six male to one female