Acute coronary syndromes and diabetes mellitus

Trichon, Benjamin H.; Roe, Matthew T.

doi:10.3132/dvdr.2004.003

Cited by 20 publications

(16 citation statements)

References 79 publications

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“…We suggest that partial occlusion of the RCA promoted damage of the parasympathetic fibers of the right vagus, and was the cause of referred otalgia and pharyngitis in our patient. Sensory nerves are affected by type 2 diabetes [4–7], but whether such a preexisting condition predisposes a person to angina-referred otalgia or pharyngitis is not clear.…”

Section: Discussionmentioning

confidence: 99%

Myocardial infarction with unusual presentation of otalgia: a case report

Amirhaeri

Spencer

2010

Int J Emerg Med

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A rare case of a patient with unusual symptoms of earache and sore throat for cardiac ischemia is presented. A diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) was made based on initial elevation of troponin and an abnormal electrocardiograph (ECG). Percutaneous coronary intervention (PCI) performed with stent placement in the occluded coronary vessel was followed by a decrease in troponin level and complete resolution of the ear and throat pain and patient recovery from cardiac ischemia.

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Section: Discussionmentioning

confidence: 99%

Myocardial infarction with unusual presentation of otalgia: a case report

Amirhaeri

Spencer

2010

Int J Emerg Med

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“…Nessa subpopulação, predominam dispnéia, sudorese, náuseas e vômitos em relação à dor torácica (16), o que leva a um retardo na procura por serviços de emergência e, conseqüentemente, posterga o início do seu tratamento (17). A interpretação de eletrocardiogramas também é mais difícil nesses pacientes, visto que as sulfoniluréias, usadas no tratamento da hiperglicemia, parecem diminuir o grau de alterações eletrocardiográficas, por uma diminuição da sensibilidade do método, reduzindo a amplitude de alterações do segmento ST e onda T (18). Durante a internação, os diabéticos apresentam taxas mais elevadas de mortalidade que os não-diabéticos.…”

Section: Características Clínicas Das Síndromes Coronarianas Agudas Eunclassified

Impacto do diabetes mellitus na mortalidade em síndromes coronarianas agudas

Braga

Santos

Flato

et al. 2007

Arq Bras Endocrinol Metab

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Diabetes mellitus (DM) is a leading cause of mortality in the world, mainly on account of cardiovascular diseases. At present we know that not only DM but also other hyperglycemic states are a risk factor for coronary arterial disease. In the context of acute coronary syndromes, DM determines a worst prognosis, either in short- or long-term outcomes. Since the absolute risk of death is greater among diabetic patients when compared to non-diabetic patients, therapeutical interventions have a greater impact in terms of benefits to these patients as well. Strategies such as strict control of hyperglycemia during hospitalization, acute reperfusion management (either by thrombolysis or by percutaneous coronary intervention), use of platelet glycoprotein IIb/IIIa inhibitors and angiotensin-converting enzyme (ACE)-inhibitors have recently proven to be of greater benefit for diabetics over non-diabetic patients. Meanwhile, in spite of all proven benefits of the use of evidence-based interventions to the treatment of acute coronary syndromes on diabetic patients, there is still an under utilization of these measures. Therefore, taking into account the predictions of an increasing number of diabetics in the world for the future years, and the fact that acute coronary syndromes will be the leading cause of death among them, it becomes increasingly necessary for both cardiologists and endocrinologists to work together in order to reduce the unfavorable outcomes that are expected to arise.

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“…Several trials have consistently shown larger relative risk reductions for pharmacotherapies in the treatment of ACSs in diabetic patients versus nondiabetic patients. Because the absolute risk is larger in diabetic patients than in nondiabetic patients, the potential absolute benefit will also be larger in diabetic patients (10,11). This fact underscores the importance of using known evidencebased treatment for all ACS patients, especially diabetic patients.…”

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confidence: 94%

Treatment Disparities in the Care of Patients With and Without Diabetes Presenting With Non–ST-Segment Elevation Acute Coronary Syndromes

et al. 2006

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OBJECTIVE -The objective of this study was to characterize treatment patterns among patients with diabetes presenting with non-ST-segment elevation (NSTE) acute coronary syndromes (ACSs). . In-hospital mortality rates were higher in insulin-treated diabetic (6.8%) and type 2 diabetic (5.4%) than in nondiabetic (4.4%) patients. RESEARCH DESIGN AND METHODSCONCLUSIONS -Diabetic patients have a higher risk of mortality than nondiabetic patients, yet physicians adhere to the ACC/AHA NSTE ACS guidelines less often when treating diabetic patients, particularly insulin-treated diabetic patients. Increased use of guideline-recommended therapies and early invasive management strategies in diabetic patients may improve their outcomes.

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Acute coronary syndromes and diabetes mellitus

Cited by 20 publications

References 79 publications

Myocardial infarction with unusual presentation of otalgia: a case report

Myocardial infarction with unusual presentation of otalgia: a case report

Impacto do diabetes mellitus na mortalidade em síndromes coronarianas agudas

Treatment Disparities in the Care of Patients With and Without Diabetes Presenting With Non–ST-Segment Elevation Acute Coronary Syndromes

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