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Jul22
CLINICAL PROFILE & PROGNOSIS OF ACUTE MYOCARDIAL INFRACTION (AMI) IN DIABETES MELLITUS.
AIM & OBJECTIVES:
To study the clinical profile and prognosis of AMI in diabetics in contrast to AMI in non-diabetics in present era of aggressive management of AMI from Janurary2003 to March 2004.

MATERIAL AND METHODS:
In present study 35 patients of AMI with diabetes mellitus and 35 patients of AMI without Diabetes mellitus in Department of General Medicine and Department of Cardiology were included. These patients were assessed & followed up in following manner.

All the patients were subjected for detail clinical examination and history at time of presentation to the hospital with special emphasis on particular complication. Serial ECG was done at Zero hour, 12 hour, 24 hour and daily till date of discharge. Routine X-ray was done in all cases to see evidences of pulmonary hypertension and other pathology. Routine biochemical investigations including liquid profile, blood urea, creatinine, glycosylated Hb, cardiac enzymes was done. Detailed Echo examination was done in all cases. All cases were critically evaluated at the time of discharge and were followed up to 30 days.

OBSERVATION:
The clinical course of acute myocardial infraction (AMI) was compared between 35 known diabetics (Ds) and 35 non-diabetics (NDs). AMI patients matched for age, sex and hospital ward. In both groups similar number of cases with shock pulmonary edema and clinical observed arrhythymias were found. In contrast, diabetic patients had significantly more frequent. A-V and intra-ventricular conduction disorder then non-diabetics (P<0.02). Diabetics also died twice more often from AMI (30%) than matched controls (15%) Diabetics with arrhythymias and/or conduction disorders had a particularly poor prognosis for surviving, the relative risk exceeding 3.

CONCLUSION:

The higher mortality and complication of AMI Diabetics calls for aggressive correction of metabolic and modifiable risk factors, treatment of acute events and secondary prevention,


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