A Comparative Study on Young Patients of Uncontrolled and Well-controlled Diabetes Mellitus Presenting with Acute Myocardial Infarction

Q: What are the key findings of this study?

Uncontrolled diabetes mellitus (HbA1c >=7.5%) was associated with higher rates of severe CAD (45% vs 25%, p=0.046) and triple-vessel disease (35% vs 15%, p=0.041) in young AMI patients.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Diabetes mellitus presenting with acute myocardial infarction (n=80). Intervention: Uncontrolled diabetes mellitus (HbA1c >=7.5%) vs. Well-controlled diabetes mellitus (HbA1c <7.5%). Primary outcome: Severe coronary artery disease on coronary angiography (p=0.046).

Q: What does this research mean for the field?

In young patients presenting with acute myocardial infarction, uncontrolled diabetes mellitus is associated with more severe, diffuse, and multivessel coronary artery disease and worse hemodynamic compromise compared to well-controlled diabetes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To compare the clinical, laboratory, echocardiographic, and coronary angiographic profiles of young patients (≤40 years) with uncontrolled versus well-controlled diabetes mellitus presenting with acute myocardial infarction.

Md. Ahasanul Haque Razib; Mahmud Hossain; Jahir Uddin Mohammed Sharif; Shah Md Atiqul Haque; Atif Ramjan Mahmoda; Shiblee Sadeque Shakil

doi:10.70818/jnmc.v03i02.0113

November 1, 2026Journal of Netrokona Medical CollegeOpen Access

A Comparative Study on Young Patients of Uncontrolled and Well-controlled Diabetes Mellitus Presenting with Acute Myocardial Infarction

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Key result

Uncontrolled diabetes linked to ~20-point higher rate of severe CAD in young AMI.

P=0.046
n=80

Why the study?

Glycemic control can influence the extent of coronary involvement in diabetic patients presenting with AMI, motivating a comparison of clinical and angiographic profiles between young AMI patients with uncontrolled versus well-controlled DM.

Does uncontrolled diabetes mellitus (HbA1c >=7.5%) increase the angiographic severity and complexity of coronary artery disease compared to well-controlled diabetes mellitus (HbA1c <7.5%) in young patients (<=40 years) presenting with acute myocardial infarction?

Key Points

To compare the clinical, laboratory, echocardiographic, and coronary angiographic profiles of young patients (≤40 years) with uncontrolled versus well-controlled diabetes mellitus presenting with acute myocardial infarction.
Cross-sectional observational study conducted from January 2025 to December 2025 at Mymensingh Medical College Hospital in Bangladesh.
Recruited 80 diabetic patients aged ≤40 years presenting with acute myocardial infarction, allocated into an uncontrolled diabetes group (HbA1c ≥7.5%; n=40) and a well-controlled diabetes group (HbA1c <7.5%; n=40).
Compared cardiovascular risk factors, acute myocardial infarction presentation, laboratory markers, left ventricular ejection fraction, and angiographic findings between groups using SPSS version 26.0.
Patients with uncontrolled diabetes exhibited significantly higher mean HbA1c (9.2 ± 1.1 vs. 6.6 ± 0.5; p<0.001), higher rates of dyslipidemia (75% vs. 50%; p=0.021), and reduced left ventricular ejection fraction (45.8 ± 8.3% vs. 49.6 ± 7.6%; p=0.027).
Angiographic evaluation revealed significantly higher rates of triple-vessel disease (35.0% vs. 15.0%; p=0.041), diffuse lesions (65.0% vs. 45.0%; p=0.048), and severe coronary artery disease (45% vs. 25%; p=0.046) in uncontrolled versus well-controlled diabetes.
Severe coronary artery disease was significantly associated with uncontrolled diabetes (64.3% vs. 42.3%; p=0.048), dyslipidemia (82.1% vs. 51.9%; p=0.008), smoking (78.6% vs. 53.8%; p=0.032), and hypertension (64.3% vs. 40.4%; p=0.039).

Study Design

Type

Cross-Sectional (n=80)

Multicenter

No

Structured PICO

Does uncontrolled diabetes mellitus (HbA1c >=7.5%) increase the angiographic severity and complexity of coronary artery disease compared to well-controlled diabetes mellitus (HbA1c <7.5%) in young patients (<=40 years) presenting with acute myocardial infarction?

P

Population

80 young adults (aged 18-40 years, 16.25% female) in Bangladesh with diabetes mellitus presenting with acute myocardial infarction and undergoing coronary angiography during index hospitalization.

E

Exposure

Uncontrolled diabetes mellitus (defined as HbA1c >=7.5%; n=40)

C

Comparator

Well-controlled diabetes mellitus (defined as HbA1c <7.5%; n=40)

O

Outcome

Severity of coronary artery disease (CAD) as measured by coronary angiography (vessel involvement, infarct-related artery, lesion pattern, and CAD severity classified as mild, moderate, or severe) during index hospitalizationsurrogate

Main Result

Absolute Event Rate: 45% vs 25%

p-value: p=0.046

In young patients (<=40 years) presenting with acute myocardial infarction, uncontrolled diabetes (HbA1c >=7.5%) is associated with significantly higher rates of triple-vessel disease, diffuse coronary lesions, severe CAD, and reduced LVEF compared to well-controlled diabetes.

Limitations

Small sample size (N=80)
Single tertiary care hospital setting limiting generalizability
Duration of diabetes was not evaluated
No long-term follow-up of clinical outcomes
Small sample size
Single tertiary care hospital setting, which may limit generalizability
Outcome was not evaluated by long-term follow-up of the study population

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Implication

Uncontrolled diabetes signals higher CAD severity in young AMI; leaves open whether glycemic optimization modifies angiographic extent.

Abstract

Background: Diabetes mellitus (DM) is a major risk factor for coronary artery disease (CAD) and acute myocardial infarction (AMI). Glycemic control can adjust the extent of coronary involvement in diabetic patients who present with acute myocardial infarction (AMI). This study aimed to compare the clinical and angiographic profile of young patients (≤40 Years) with Uncontrolled and Well-controlled diabetes mellitus (DM) presenting with acute myocardial infarction. Methods: This cross-sectional observational study was conducted at the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2025 to December 2025. Eighty diabetic patients presented with AMI, aged ≤40 years were recruited and equally divided into two groups: Uncontrolled DM (HbA1c ≥7.5%; n=40) and Well-controlled DM (HbA1c <7.5%; n=40). The socio-demographic characteristics, cardiovascular risk factors, clinical presentation, laboratory parameters, echocardiographic findings, and coronary angiographic profile were documented and compared between the two groups. Data were entered and analyzed using SPSS version 26.0. Results: The mean HbA1c was significantly higher in the uncontrolled DM group (9.2 ± 1.1 vs. 6.6 ± 0.5; p<0.001). The only cardiovascular risk factor that significantly differed between the two groups was dyslipidemia (75% vs. 50%; p=0.021). The uncontrolled DM group had a higher frequency of STEMI (75% vs. 62.5%), higher rates of atypical presentation (25% vs. 15%), delayed hospital arrival (62.5% vs. 45%), and a higher Killip class (II–IV: 40% vs. 25%). Laboratory parameters, such as LDL-C, triglycerides, and fasting glucose, were significantly higher in uncontrolled DM patients, whereas LVEF was lower in uncontrolled DM patients group. Angiographically, triple-vessel disease (35.0% vs. 15.0%; p=0.041), diffuse lesion pattern (65% vs. 45%; p=0.048), and severe CAD (45% vs. 25%; p=0.046) were significantly more common in uncontrolled DM patients. Uncontrolled DM, dyslipidemia, smoking, and hypertension were significantly associated with severe coronary artery disease. Conclusion: Uncontrolled diabetes mellitus is independently related to more extensive myocardial damage with worse haemodynamic status and more severe, diffuse, and multi-vessel coronary artery disease in young patients (≤40 Years) presenting with acute myocardial infarction. These results highlight the paramount significance of optimal glycemic control to reduce the burden and severity of CAD in young diabetic patients.

Discussion

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Cite This Study

Razib et al. (2026) conducted a cross-sectional in Diabetes mellitus presenting with acute myocardial infarction (n=80). Uncontrolled diabetes mellitus (HbA1c >=7.5%) vs. Well-controlled diabetes mellitus (HbA1c <7.5%) was evaluated on Severe coronary artery disease on coronary angiography (p=0.046). Uncontrolled diabetes mellitus (HbA1c >=7.5%) was associated with higher rates of severe CAD (45% vs 25%, p=0.046) and triple-vessel disease (35% vs 15%, p=0.041) in young AMI patients.

synapsesocial.com/papers/6ae92596a8a6b2adf62f5fff https://doi.org/10.70818/jnmc.v03i02.0113

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A Comparative Study on Young Patients of Uncontrolled and Well-controlled Diabetes Mellitus Presenting with Acute Myocardial Infarction

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

A Comparative Study on Young Patients of Uncontrolled and Well-controlled Diabetes Mellitus Presenting with Acute Myocardial Infarction

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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