Comparison of Clinical and Angiographic Characteristics of Diabetic and Non-Diabetic Patients With Acute Myocardial Infarction

Abstract

Objectives: In this study, we evaluated the differences in clinical and angiographic profiles of ST-segment elevation myocardial infarction (STEMI) patients with and without diabetes mellitus (DM) at a tertiary care cardiac hospital in Karachi, Pakistan. Methodology: This descriptive cross-sectional study was conducted at a tertiary care cardiac hospital in Karachi, Pakistan. The study included consecutive adult patients (≥ 18 years of age) diagnosed with STEMI undergoing primary percutaneous coronary intervention (PCI). Diabetic and non-diabetic patients were compared for clinical and angiographic profiles. Results: The study sample consisted of 43.8% (218) diabetic patients. The mean age was 59.03 ± 9.69 years vs. 49.54 ± 11.53 years; p<0.001, proportion of females was 35.3% (77) vs. 14.6% (41); p<0.001, Killip class III or IV was (17) vs. 2.5% (7), and hypertension was 83% (181) vs. 56.8% (159); p<0.001 among the diabetic and non-diabetic group, respectively. The frequency of multi-vessel disease was 50.9% (111) vs. 39.6% (111), the significant left main disease was 5% (11) vs. 2.5% (7), and initial TIMI III flow was 19.3% (42) vs. 25.4% (71) in diabetic and non-diabetic patients, respectively. Conclusion: In conclusion, diabetes in STEMI setting is associated with complex coronary artery diseases, more hemodynamic instability at presentation, and the presence of multiple co-morbid conditions.