Differences between diabetic and non-diabetic hypertensive patients with first acute non-ST elevation myocardial infarction and predictors of in-hospital complications

Colivicchi, Furio; Mettimano, Marco; Genovesi-Ebert, A; Schinzari, Francesca; Melina, Giovanni; Santini, Massimo; Cardillo, Carmine; Melina, D

doi:10.2459/jcm.0b013e328058680b

Cited by 5 publications

(4 citation statements)

References 29 publications

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“…No statistically significant (p>0.05) difference was observed between two groups. This is consistent with the study conducted by Colivicchi et al (2008) where that mean age of diabetic patients was 54±2 years and of non-diabetic patients was 56±5 years 5 . The present observation is also similar to a study done in Bangladesh by Salim et al (2015) which revealed that mean age was 58.7 ± 10.7 years in diabetic patients and 57.3 ± 13.2 years in non-diabetic patients with no statistically significant difference 15 .…”

Section: Table-vii Univariate Logistic Regression Analysis Showing Od...supporting

confidence: 93%

“…This association has a negative impact on prognosis by strongly predisposing the individual patient to the development of an accelerated atherosclerotic cardiovascular disease. Consequently, diabetic hypertensive subjects have a higher incidence of coronary artery disease than patients with diabetes or hypertension alone 5 . Patients with diabetes who develop a NSTEMI are at increased risk for each hospital outcome including heart failure, renal failure, cardiogenic shock and death 6 .…”

Section: Introductionmentioning

confidence: 99%

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Hospital Outcome of Hypertensive Non-ST Elevation Myocardial Infarction Patients in Diabetic and Non-Diabetic Groups

Matin,

Ali,

Haq

2024

Bangladesh Heart J

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Objective: Acute myocardial infarction is one of the leading causes of all acute emergencies and is becoming an important public health problem in the developing countries. Non-ST elevation myocardial infarction (NSTEMI) is more heterogeneous in their presentation and may be poorly characterized in clinical practice, leading to greater variation in diagnosis and treatment. Patients with diabetes and hypertension who develop a NSTEMI are at increased risk for poor hospital outcome. This study is aimed to assess the differences between hypertensive diabetic and hypertensive non-diabetic patients with NSTEMI and to evaluate the prognostic impact of selected clinical and laboratory parameters on the occurrence of hospital complications. Methods: This was a cross-sectional analytical study. All the adult hypertensive patients of newly diagnosed NSTEMI with or without diabetes mellitus admitted in Ibrahim Cardiac Hospital & Research Institute, Dhaka who fulfilled the inclusion and exclusion criteria were enrolled. The study population comprised of 100 hypertensive patients with their first NSTEMI, and were divided into two groups according to the presence of type 2 diabetes mellitus. Group I (n = 40) patients were diabetic and Group II (n = 60) were non-diabetic. Hospital outcome of the study population was recorded. The incidence of in hospital adverse clinical events in the two groups was compared by using the odds ratio of the two binomial proportion analyses. Results: Among 100 hypertensive NSTEMI patients, 40% were diabetic (Group I) and 60% were non-diabetic (Group II). Mean age was 58.1±10.2 years in case of diabetic group (Group I) and 56.3±10.5 years in non-diabetic group (Group II) ranging from 30-70 years. Male patients (66%) were predominant in the study. Most common clinical presentation was chest pain which was 77.5% in Group I and 83.3 % in Group II followed by sweating (12.5% and 16.7%), dyspnea (10.0% and 11.7%), syncope (5.0% and 6.7%) and atypical chest pain (2.5% and 3.3%) respectively. Smoking was the commonest risk factor which was 62.5% in Group I and 75% in Group II followed by dyslipidemia (32.5% and 36.7%), family history of IHD (30% and 23.3%) and obesity (22.5% and 13.3%) respectively. Diabetic hypertensive patients had significantly higher heart rate, hypertensive peaks and more episodes of asymptomatic ST segment depression. Most common in hospital complications were heart failure (30% and 16.7%), arrhythmias (22.5% and 6.7%), renal failure (10% and 5.0%), cerebral ischemia (7.5% and 1.7%), death (7.5% and 3.3%) and cardiogenic shock (5.0% and 3.3%) in Group I and Group II respectively. Conclusion: In hospitals, adverse clinical events were more frequent in diabetic hypertensive individuals compared to non-diabetics. Bangladesh Heart Journal 2024; 39(1): 17-23

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Section: Table-vii Univariate Logistic Regression Analysis Showing Od...supporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Hospital Outcome of Hypertensive Non-ST Elevation Myocardial Infarction Patients in Diabetic and Non-Diabetic Groups

Matin,

Ali,

Haq

2024

Bangladesh Heart J

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“…There is a general agreement that coexistence of diabetes and hypertension is associated with a higher cardiovascular risk and mortality in humans (Endemann et al. 2004; Colivicchi et al. 2008) and animal models (Hendriks et al.…”

mentioning

confidence: 99%

“…In addition, 87.2% of African-American subjects with obesity and high-blood pressure exhibited insulin-resistance (Campbell et al 2004). There is a general agreement that coexistence of diabetes and hypertension is associated with a higher cardiovascular risk and mortality in humans (Endemann et al 2004;Colivicchi et al 2008) and animal models (Hendriks et al 1993;Ballo et al 2010).…”

mentioning

confidence: 99%

Simultaneous renal hypertension and type 2 diabetes exacerbate vascular endothelial dysfunction in rats

Khalili

Nekooeian

Khosravi

et al. 2012

Int J Experimental Path

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Despite the high rate of occurrence of both diabetes and hypertension in humans, the cardiovascular effects of the two conditions have not been investigated when they occur simultaneously. Thus this study examined the vascular effects of simultaneous type 2 diabetes and renal hypertension on endothelial function. Serum malondialdehyde and systolic blood pressure (SBP) were measured, glucose tolerance test (GTT) was performed, and concentration-response to phenylephrine (PE) in the absence and presence of nitro-l-arginine methyl ester (l-NAME), acetylcholine and sodium nitroprusside were conducted on aortic rings from diabetic control, type 2 diabetes, sham-operated, renal hypertensive, and simultaneous type 2 diabetes plus hypertension rats respectively. Hypertension, diabetes, and simultaneous diabetes and hypertension were associated with either increased or decreased maximal responses (E(max)) of PE dependent on in the presence or absence of l-NAME. There was also increased serum malondialdehyde and decreased E(max) of acetylcholine. Thus simultaneous hypertension and diabetes caused a greater decrease in E(max) of acetylcholine compared to that seen with either diabetes or hypertension alone higher than that seen in hypertension. The blood glucose during GTT was lower than that seen in diabetes groups. Thus simultaneous type 2 diabetes and the SBP was renal hypertension is associated with improved glucose tolerance, but with further deterioration of endothelial dysfunction compared with either condition alone.

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Mild heart failure is a mortality marker after a non-ST-segment acute myocardial infarction

Núñez‐Gil

Garcı́a-Rubira

Luaces

et al. 2010

European Journal of Internal Medicine

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Differences between diabetic and non-diabetic hypertensive patients with first acute non-ST elevation myocardial infarction and predictors of in-hospital complications

Cited by 5 publications

References 29 publications

Hospital Outcome of Hypertensive Non-ST Elevation Myocardial Infarction Patients in Diabetic and Non-Diabetic Groups

Hospital Outcome of Hypertensive Non-ST Elevation Myocardial Infarction Patients in Diabetic and Non-Diabetic Groups

Simultaneous renal hypertension and type 2 diabetes exacerbate vascular endothelial dysfunction in rats

Mild heart failure is a mortality marker after a non-ST-segment acute myocardial infarction

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