DIABETES AS A RISK FACTOR OF IN – HOSPITAL MORTALITY IN PATIENTS WITH PREMATURE CORONAY DISEASE PRESENTING WITH ACUTE MYOCARDIAL INFARCTION.

Abstract

Background; Recent data from various parts of the world have led to the conclusion that more than 80 % of CVD deaths occur in developing countries like Pakistan. This high burden of heart diseases is largely attributed to the industrial and technological progress which is associated with economic and social transformations which have lead to life style modification and sedentary life style. This study was planned to ascertain mortality rate of premature coronary artery disease in patients with AMI as it directly affects main workforce of our national economy. Objective; To determine role of diabetes with mortality in premature coronary artery disease patients with acute myocardial infarction.  Material and methods; A total of 145 patients having premature coronary artery disease presenting with acute myocardial infarction were included in this descriptive study. This study was conducted in the department of medicine, Nishtar Hospital, Multan from June 2018 to May 2019. These patients were followed during current hospitalization to see mortality in these patients and all the findings were noted in the proforma. Results; Of these 145 study cases, 96 (66.2%) were male patients and 49 (33.8%) were female patients. Mean age of our study cases was noted to be 47.67 ± 7.59 years. Mean time taken before presentation at hospital was 113.79 ± 54.36 minutes. Hypertension was present in 58 (40%), smoking in 39 (26.9%), family history of IHD in 67 (46.2%) and obesity in 49 (33.8%) of our study cases. Mortality was noted to be in 19 (13.1%) of our study cases, post MI angina was seen in 36 (24.8%) and cardiogenic shock was noted in 29 (20%). Diabetes was present in 48 (33.1%) of our study cases while in – hospital mortality among diabetic patients was 18 /48 (37.5%) (p=0.001). Conclusion; Our study results indicate that diabetic patients with premature coronary artery disease having acute myocardial infarction (AMI) have high rates of mortality. Positive family history, hypertension, obesity and diabetes were major risk factors noted in our study. Life style modification and early screening of the cases with positive family history in first degree relatives can help prevent heart diseases in our population as it hits main workforce and has negative impact on national productivity. Keywords; Premature coronary artery disease, mortality, diabetes, Myocardial infarction. DOI : 10.7176/JMPB/55-14 Publication date :May 31 st 2019