Diabetes mellitus type 2 and acute myocardial infarction: prognostic options for interaction in patients of different age groups
https://doi.org/10.14341/DM8828
Abstract
Background. Problems surrounding comorbidities of type 2 diabetes mellitus and coronary heart disease are some of the most important in medical science and practice, given their mutually negative impact on patients’ prognoses and quality of life.
Aims. To study the impact of type 2 diabetes on the long-term prognoses of patients of different age categories, status-post acute myocardial infarction. (Data obtained from the ‘Register of Acute Myocardial Infarction’.)
Materials and methods. The main data source was the ‘Register of Acute Myocardial Infarction’, maintained in Tomsk for more than 30 years. The study included 862 patients with acute myocardial infarction. The patients were monitored for 5 years. The primary endpoint was death from any cause during the observation period.
Results. We separated the study cohort into 2 groups depending on patients’ ages: Group 1 (n = 358) included patients older than working age, Group 2 (n = 504) consisted of younger, employable patients. The combination of ischaemic heart disease and type 2 diabetes mellitus were diagnosed in 208 patients. The combination of ischaemic heart disease and type 2 diabetes was the cause of adverse prognosis among elderly patients and led to increased mortality rate during the 5-year post-infarction period (p = 0.0003). However, among younger, working patients who suffered myocardial infarction, the presence of type 2 diabetes did not have an independent negative effect on long-term disease prognosis. While in employable patients, a long history of diabetes mellitus significantly aggravated the course of the post-infarction period (p = 0.004).
Conclusions. These data suggest an ambiguous prognostic effect of type 2 diabetes mellitus among working age and elderly patients status post myocardial infarction, in agreement with experimental studies conducted on laboratory animals. Further comprehensive analyses of the clinical and experimental data are needed to optimise therapies for patients who suffer from type 2 diabetes and comorbid ischaemic heart disease.
About the Authors
Alla A. GarganeevaTomsk National Research Medical Centre, Russian Academy of Sciences
Russian Federation
MD, PhD, Professor
Elena A. Kuzheleva
Tomsk National Research Medical Centre, Russian Academy of Sciences
Russian Federation
MD, PhD
Ksenia N. Borel
Ltd. «ARMED»
Russian Federation
MD, PhD
Dina S. Kondratyeva
Tomsk National Research Medical Centre, Russian Academy of Sciences
Russian Federation
PhD in Biology
Sergey A. Afanasiev
Tomsk National Research Medical Centre, Russian Academy of Sciences
Russian Federation
MD, PhD, Professor
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Supplementary files
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1. Рисунок 1 - Динамика уровня летальности от острого инфаркта миокарда в период аномально жаркой погоды | |
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2. Рисунок 2 - Влияние наличия сахарного диабета на отдаленный прогноз заболевания у пациентов трудоспособного возраста, перенесших инфаркт миокарда | |
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3. Рисунок 3 - Выживаемость больных, перенесших острый инфаркт миокарда, в зависимости от длительности сахарного диабета | |
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4. Fig.1. Effect of CD2 on the long-term prognosis of the disease in patients older than working age who underwent myocardial infarction. | |
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5. Fig.2. The effect of the presence of DM2 on the long-term prognosis of the disease in patients of working age who underwent myocardial infarction. | |
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6. Fig.3. Survival of patients with acute myocardial infarction, depending on the duration of diabetes mellitus. | |
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Review
For citations:
Garganeeva A.A., Kuzheleva E.A., Borel K.N., Kondratyeva D.S., Afanasiev S.A. Diabetes mellitus type 2 and acute myocardial infarction: prognostic options for interaction in patients of different age groups. Diabetes mellitus. 2018;21(2):105-112. (In Russ.) https://doi.org/10.14341/DM8828

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