Comparision of in-hospital complications between diabetic hypertensive and diabetic normotensive patients with acute myocardial infarction

ABSTRACT

To compare the frequency of in-hospital complications between diabetic hypertensive and diabetic normotensive patients presenting with acute myocardial infarction [MI]. This observational cohort study was carried out in the department of Cardiology, Lady Reading Hospital, Peshawar. A total of 444 diabetic patients with acute MI were studied from December 2009 to September 2011. Among these half of patients were hypertensive while rests were normotensive. After enrolment in the study, patients were monitored for in- hospital complications of acute MI. Most of the baseline characteristics were similar between the two groups of patients. However patients in diabetic hyper tensive group had a long history of diabetes, high heart rate and blood pressure on presentation. Complication rates were not different statistically between the two groups. Complication rates between diabetic hypertensive and diabetic normotensive groups were; atrial fibrillation [AF] 15.3% vs. 12.12% p=0.204 respectively while ventricular tachycardia [VT] 14% vs. 12.6% p=0.390, ventricular fibrillation [VF] 4.5% vs. 3.8% p=0.405, type 1 second degree heart block 8.6% vs. 6.8% p=0.296, type 2 second degree heart block 2.3% vs. 1.4% p=0.362, complete heart block[CHB] 11.7% vs. 9.9% p=0.323, acute congestive heart failure [CHF] 13.1% vs. 9.5% p=0.269, left ventricular failure [LVF] 19.9% Vs 16.7% p=0.147, cardiogenic shock[CS] 14% vs. 10.4% p=0.080, recurrent MI [Re-MI] 14% vs. 10.8% p=0.194 and death rate 14% vs. 12.2% p=0.336 respectively. Hypertension in diabetic patients is not associated with an increase risk of in-hospital complications after acute MI