Myocardial infarct size and mortality in diabetic patients.

Abstract

The mortality rate from myocardial infarction is disproportionately high in diabetic patients. One explanation for this may be that diabetic patients incur more extensive myocardial necrosis. This possibility was examined in a three part study. Firstly, peak serum aspartate aminotransferase concentrations of all diabetic and non-diabetic patients admitted with myocardial infarction over a 16 year period were compared retrospectively. Secondly, peak aspartate aminotransferase concentrations in a series of diabetic patients and controls matched by age and sex were examined retrospectively. Thirdly, creatine kinase MB release and electrocardiographic measures of infarct size were investigated prospectively in a case/control study. Although cardiac failure and death were more common in the diabetic groups, there were no significant differences in estimates of infarct size between diabetic and non-diabetic patients in any of the studies. Therefore, the high case fatality rate amongst diabetic patients is not caused by increased myocardial damage. Presumably survival is prejudiced by factors operating before the infarction.

Diabetes mellitus and congestive heart failure

“…This relationship was confirmed by the RESOLVD trial [14] . Diabetic patients also experience a higher incidence of heart failure and increased mortality after acute myocardial infarction than nondiabetic patients [20][21][22][23] . In the DIGAMI (Diabetes mellitus Insulin-Glucose infusion in Acute Myocardial Infarction) study, cohort heart failure was the most common reason for morbidity and mortality accounting for 66% of the total mortality during the first year of follow-up [24] .…”

Targeting Intermediary Metabolism in the Hypothalamus as a Mechanism to Regulate Appetite

“…In particular, the incidence of diabetes itself is growing at a rate of 6% annually (Partamian and Bradley, 1965;Kopelman and Hitman, 1998;Kopelman, 2000). This is disconcerting because diabetes is associated with a high incidence of complications, including heart disease and stroke (Kannel and McGee, 1979;Gwilt et al, 1985;Ulvenstam et al, 1985;Ingelsson et al, 2005).…”

Glucose and Palmitic Acid Induce Degeneration of Myofibrils and Modulate Apoptosis in Rat Adult Cardiomyocytes

“…Diabetes 50: 2105-2113, 2001 I t has long been known that diabetes has major cardiovascular effects and is a risk factor for ischemic heart disease. Moreover, patients with diabetes have a markedly adverse course after myocardial infarction, with high rates of postinfarction heart failure and death (1,2). Several studies support the concept of a specific diabetic cardiomyopathy, i.e., cardiac abnormalities in the absence of discernible coronary artery disease, hypertension, or valvular disease (3,4).…”