Key result
Diabetes is linked to nearly three-fold higher rates of atypical MI symptoms like epigastric pain.
Why the study?
Diabetic patients with myocardial infarction often exhibit atypical or less pronounced symptoms, which may delay diagnosis and treatment, necessitating understanding of symptom variation between diabetic and non-diabetic patients.
Does diabetes alter the clinical presentation of myocardial infarction in adult patients?
Cross-Sectional (n=164)
No
Does diabetes alter the clinical presentation of myocardial infarction in adult patients?
Absolute Event Rate: 16.5% vs 5.9%
p-value: p=0.03
Diabetic patients with myocardial infarction are more likely to present with atypical symptoms such as epigastric pain, anxiety, and cold sweats, necessitating broader diagnostic suspicion.
May delay MI diagnosis in diabetics; hypothesis-generating for symptom-based protocols, needs prospective validation before practice change.
Background: Myocardial infarction (MI) presents with a spectrum of symptoms, and diabetic patients often exhibit atypical or less pronounced presentations, which may delay diagnosis and treatment. Understanding the variation in symptomatology between diabetic and non-diabetic patients is essential for timely intervention. Objective: To determine the frequency of various clinical presentations of myocardial infarction and compare symptom patterns between diabetic and non-diabetic patients. Study Design: Cross-sectional observational study. Setting: Cardiology Department, Rehman Medical Institute, Peshawar. Duration of Study: From February 23, 2025, to May 23, 2025. Methods: A total of 164 patients (both diabetic and non-diabetic), aged 35 to 90 years, and diagnosed with MI were included. Clinical symptoms such as chest pain, arm pain, epigastric pain, jaw pain, nausea/vomiting, anxiety, and cold sweats were recorded and compared between the diabetic and non-diabetic groups. Data were analysed using descriptive statistics and Chi-square tests, with a p-value <0.05 considered statistically significant. Results: The mean age of participants was 65.7 ± 16.47 years, with males comprising 56.7% of the cohort. Chest pain was the most commonly reported symptom (72%). Diabetic patients had a significantly higher frequency of epigastric pain (16.5%, p = 0.03), anxiety (32.9%, p = 0.01), and cold sweats (43.0%, p = 0.04) compared to non-diabetics. Other symptoms, such as arm pain, jaw pain, and nausea/vomiting, showed no statistically significant differences between the two groups. Conclusion: Chest pain remains the predominant presenting symptom in both diabetic and non-diabetic MI patients. However, diabetic patients are more likely to present with atypical symptoms such as epigastric pain, anxiety, and cold sweats. These findings underscore the need for heightened clinical suspicion and broader diagnostic criteria when assessing diabetic patients for MI.
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KHAN et al. (2025) conducted a cross-sectional in Myocardial Infarction (n=164). Diabetes Mellitus vs. Non-diabetic was evaluated on Epigastric pain presentation (p=0.03). Diabetic patients with myocardial infarction presented with a significantly higher frequency of atypical symptoms such as epigastric pain, anxiety, and cold sweats compared to non-diabetic patients.
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