Journal of internal medicine · 1999
Comparison of secondary prevention measures after myocardial infarction in subjects with and without diabetes mellitus.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Chowdhury T A, Lasker S S, Dyer P H
Аннотация
OBJECTIVES: To survey and compare secondary prevention measures in diabetic and non-diabetic patients following myocardial infarction (MI).
DESIGN: Follow-up of a cohort of patients who suffered their first MI 1 year previously.
SETTING: Three district general hospitals.
MAIN OUTCOME MEASURES: Review 1 year post-MI for signs of left ventricular failure (LVF), serum cholesterol, smoking status, weight, blood pressure and glycaemic control. Assessment of appropriate treatment with aspirin, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors and lipid-lowering therapy before discharge and at least 1 year post-MI.
RESULTS: A total of 189 non-diabetic and 86 diabetic patients were studied. Most patients received beta-blockers and aspirin appropriately, and most gave up smoking. In non-diabetic subjects, cholesterol fell significantly (P < 0.05), as did the proportion of patients with cholesterol > 5.5 mmol L(-1) (P < 0.05), whereas cholesterol did not fall significantly in diabetic subjects, due to a lower proportion of patients being on lipid-lowering therapy (27.5 vs. 37.9%). A higher proportion of non-diabetic patients with LVF were treated with ACE inhibitors compared with diabetic subjects (73.6 vs. 61.%). Glycaemic control did not improve in the diabetic subjects.
CONCLUSIONS: Patients with diabetes do not receive optimal secondary prevention measures compared with their non-diabetic counterparts. This issue needs to be addressed by all units dealing with patients with diabetes in order to reduce the mortality and morbidity of MI in such patients.
DESIGN: Follow-up of a cohort of patients who suffered their first MI 1 year previously.
SETTING: Three district general hospitals.
MAIN OUTCOME MEASURES: Review 1 year post-MI for signs of left ventricular failure (LVF), serum cholesterol, smoking status, weight, blood pressure and glycaemic control. Assessment of appropriate treatment with aspirin, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors and lipid-lowering therapy before discharge and at least 1 year post-MI.
RESULTS: A total of 189 non-diabetic and 86 diabetic patients were studied. Most patients received beta-blockers and aspirin appropriately, and most gave up smoking. In non-diabetic subjects, cholesterol fell significantly (P < 0.05), as did the proportion of patients with cholesterol > 5.5 mmol L(-1) (P < 0.05), whereas cholesterol did not fall significantly in diabetic subjects, due to a lower proportion of patients being on lipid-lowering therapy (27.5 vs. 37.9%). A higher proportion of non-diabetic patients with LVF were treated with ACE inhibitors compared with diabetic subjects (73.6 vs. 61.%). Glycaemic control did not improve in the diabetic subjects.
CONCLUSIONS: Patients with diabetes do not receive optimal secondary prevention measures compared with their non-diabetic counterparts. This issue needs to be addressed by all units dealing with patients with diabetes in order to reduce the mortality and morbidity of MI in such patients.