Depressed HRV is an independent predictor of mortality in post-infarction patients and may provide useful additional prognostic information in non-invasive risk stratification of these patients.

Intrahospital mortality was significantly higher in diabetic than in nondiabetic patients. Identically the mortality after more than 10 years of the follow up after the first AMI was significantly higher in diabetic with, than in diabetic patients without CDAN, as in diabetic than in nondiabetic patients.

The impact of late percutaneous coronary intervention (PCI) in the patients after acute myocardial infarction (AMI) on long term mortality remains to be established. At currently, thrombolysis is accepted as standard therapy when PCI is not immediately available. However, PCI is often performed in stable patients with AMI who are/are not received thrombolysis . We performed the trial that enrolled myocardial infarction patients treated with thrombolysis, late PCI and medically to assess the potential benefits of delayed PCI. We follow up 164 consecutive patients after AMI one year. The patients are divided in two groups; first group-66 patients who received reperfusion (37 patients received only thrombolysis, 10 patients received thrombolysis and PCI 7-9 days after thrombolysis and 19 patients underwent only PCI after 7-9 days) and second group-98 patients medically treated. One year mortality was 3% in the reperfusion group (2/66) and 14,3% in the medical group (14/98) (p=0,016). There were not significant differences between groups about other end points-reinfarctus, coronary artery bypass surgery and PCI performed later after discharge. The major predictors of one year mortality were ages (p<0,001) and ejection fraction (p=0,003). Also, therapy with beta-blockers (p=0,002), statins (p=0,001) and ACE-inhibitors (p=0,024) was associated with better survival. Delayed PCI performed 7-9 days after AMI in the patients who underwent thrombolysis or those did not improves outcome at long-term follow-up.

Introduction/Objective. Cardiovascular diabetic autonomic neuropathy (CDAN) mainly affects heart rhythm through sympathovagal imbalance. The objective of the study is to determine CDAN risk potential regarding electrical complications of acute myocardial ischemia (AMI), including admission glucose profile levels (AGP). Methods. Seventy-six patients suffering from type 2 diabetes mellitus were divided into two age-matched groups related to the presence of CDAN, and the influence of AGP on electrical complications was estimated. Ewing?s tests were used for diagnosis of CDAN. Results. Patients without CDAN have 42.86% risk for developing electrical complication into early post-AMI period. If it is a pre-existing condition, the risk is 63.64%, which is obvious, but not statistically significant. Considering the AGP, levels above 12.25 mmol/L as predictive for post-AMI electrical complications, in CDAN-positive patients with AGP levels above that cut-off value, the risk for electrical complications is raising up to 73.68%. The patients with CDAN who have AGP levels above the cut-off value have statistically higher risk for development electrical complications than those with lower levels (Z = 2.58, p < 0.01). On the other side, those without CDAN and with level of AGP lower than 12.25 mmol/L, the risk for electrical complications developing is as low as 23.08%. Conclusion. CDAN may be an important independent risk factor for electrical complications in postmyocardial ischemia period.

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