Key result
~61% of AMI patients without known diabetes exhibit abnormal glucose metabolism at three months.
Why the study?
Metabolic condition upon hospital admission is a significant risk factor for long-term mortality in acute myocardial infarction patients regardless of prior diabetes diagnosis.
Cohort (n=100)
Yes
A significant proportion of patients presenting with acute myocardial infarction without known diabetes have previously undetected diabetes or impaired glucose tolerance, highlighting the importance of routine glucose tolerance screening in this population.
Early screening for abnormal glucose metabolism may identify higher-risk nondiabetic AMI patients; leaves open whether intervention improves survival.
Background: Whether or not a patient has been diagnosed with diabetes mellitus, their metabolic condition upon hospital admission is a significant risk factor for long-term mortality in patients who have had an acute myocardial infarction. Objectives: Our objectives were to determine the frequency of abnormal glucose metabolism in myocardial infarction patients who did not have a diagnosis of diabetes and to determine if these abnormalities might be detected early in the myocardial infarction. Study Design: A Prospective Study Place and duration of study: Department of Diabetes & Endocrinology & Cardiology HMC Hospital Peshawar from 1st Jan 2021 to 1st july- 2022 Methods: We conducted a prospective study in which we included 100 consecutive acute myocardial infarction patients hospitalized in the coronary care units of two Swedish hospitals. The patients did not have a diagnosis of diabetes and had blood glucose levels below 11.1 mmol/L. During the hospital stay, we monitored glucose levels and performed standardized oral glucose tolerance tests using 75 g of glucose upon discharge and then again after three months. Results: Our cohort's mean age was 65.06 years (SD 09), and upon admission, its mean blood glucose level was 06.05 mmol/L (01.03). At hospital discharge, the mean 02-h post-load blood glucose concentration was 09.01 mmol/L (02.08), and three months later, it was 08.0 mmol/L (02.1). At discharge and after three months, respectively, 34 of 100 (34%, 96% CI 26-41) and 38 of 100 (38%, 30-43) patients had impaired glucose tolerance; 32 of 100 (32%, 22-35) and 23 of 100 (23%, 22-28) patients had previously undetected diabetes mellitus. Concentrations of HbA(01c) at admission (p=0.022) and fasting blood glucose concentrations on day 06 (p=0.042) were independent predictors of impaired glucose tolerance at three months. Conclusion : This future study emphasizes how common aberrant glucose metabolism is in individuals who have had an acute myocardial infarction but have not previously been diagnosed with diabetes. Reducing the risk of long-term mortality requires early diagnosis and care of these disorders. Future glucose tolerance problems may be predicted using variables such as fasting blood glucose concentrations and HbA1c levels.
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Afridi et al. (2024) conducted a cohort in Acute myocardial infarction (n=100). Acute myocardial infarction without known diabetes was evaluated on Impaired glucose tolerance at three months (95% CI 30-43). Among acute myocardial infarction patients without known diabetes, 38% had impaired glucose tolerance and 23% had previously undetected diabetes mellitus at 3 months.
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