COMPARISION OF IN-HOSPITAL COMPLICATIONS BETWEEN DIABETIC HYPERTENSIVE AND DIABETIC NORMOTENSIVE PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Abstract

Objective: To compare the frequency of in-hospital complications betweendiabetic hypertensive and diabetic normotensive patients presenting with acutemyocardial infarction (MI).

Methodology: This observational cohort study was carried out in the departmentof Cardiology, Lady Reading Hospital, Peshawar. A total of 444 diabetic patientswith acute MI were studied from December 2009 to September 2011. Amongthese half of patients were hypertensive while rests were normotensive. Afterenrolment in the study, patients were monitored for in- hospital complications ofacute MI.

Results: Most of the baseline characteristics were similar between the twogroups of patients. However patients in diabetic hyper tensive group had a longhistory of diabetes, high heart rate and blood pressure on presentation.Complication rates were not different statistically between the two groups.Complication rates between diabetic hypertensive and diabetic normotensivegroups were; atrial fibrillation (AF) 15.3% vs. 12.12% p=0.204 respectivelywhile ventricular tachycardia (VT) 14% vs. 12.6% p=0.390, ventricularfibrillation (VF) 4.5% vs. 3.8 % p=0.405, type 1 second degree heart block 8.6%vs. 6.8 % p=0.296, type 2 second degree heart block 2.3% vs. 1.4% p=0.362,complete heart block(CHB) 11.7% vs. 9.9% p=0.323, acute congestive heartfailure (CHF) 13.1% vs. 9.5% p=0.269, left ventricular failure (LVF) 19.9% Vs16.7% p=0.147, cardiogenic shock(CS) 14% vs. 10.4% p=0.080, recurrent MI(Re-MI) 14% vs. 10.8% p=0.194 and death rate 14 % vs. 12.2 % p=0.336respectively.

Conclusion: Hypertension in diabetic patients is not associated with an increase risk of in-hospital complications after acute MI.