Wiadomosci lekarskie (Warsaw, Poland : 1960) · 2016
Peculiarities of heart rate in the patients with unstable angina and non-ST elevation myocardial infarction and concomitant diabetes mellitus type 2.
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Hryhoriy Kyyak
Аннотация
INTRODUCTION: type 2 diabetes mellitus is one of the most important medical and social problems in the world. Patients with diabetes are prone to coronary artery disease, in particular acute coronary syndrome, with atypical clinical signs and susceptibility to tachycardia. Elevated heart rate is an important factor of premature mortality in all patients with acute coronary syndrome. The aim of the investigation was to reveal the heart rate peculiarities in unstable angina and non-ST elevation myocardial infarction patients suffering from diabetes mellitus type 2 for more effective treatment of these patients.
MATERIALS AND METHODS: 40 patients with unstable angina and non-ST elevation myocardial infarction were examined in the consecutive way during 2013- 2015 years. The patients were divided in two groups. The main group consisted of 25 patients with UA and NSTEMI with concomitant DM. The control group consisted of 15 patients with UA and NSTEMI but without DM. Basic clinical examinations, electrocardiography and 24 hours electrocardiography monitoring were performed. Carvedilol in the dose from 12.5 to 25 mg daily was also prescribed.
RESULTS: we revealed statistically higher heart rate in the patients with unstable angina, non-ST elevation myocardial infarction and concomitant DM on hospitalization, at the fifth day of treatment and before their discharge from the hospital.
CONCLUSIONS: 1. Patients with unstable angina and non-ST elevation myocardial infarction in associations with diabetes mellitus type 2 are characterized with increased heart rate partly resistant to β-blockers, which indicates worse prognosis of cardiovascular diseases. 2. Prescription of carvedilol in daily dose 12.5 - 25 mg. is inadequate for obtaining HR < 70 bmp. in some patients with acute coronary syndrome and diabetes mellitus. 3. According to heart rate resistance to β-blockers in patients with unstable angina and non-ST elevation myocardial infarction and concomitant diabetes mellitus patients need individual titration of higher doses of carvedilol.
MATERIALS AND METHODS: 40 patients with unstable angina and non-ST elevation myocardial infarction were examined in the consecutive way during 2013- 2015 years. The patients were divided in two groups. The main group consisted of 25 patients with UA and NSTEMI with concomitant DM. The control group consisted of 15 patients with UA and NSTEMI but without DM. Basic clinical examinations, electrocardiography and 24 hours electrocardiography monitoring were performed. Carvedilol in the dose from 12.5 to 25 mg daily was also prescribed.
RESULTS: we revealed statistically higher heart rate in the patients with unstable angina, non-ST elevation myocardial infarction and concomitant DM on hospitalization, at the fifth day of treatment and before their discharge from the hospital.
CONCLUSIONS: 1. Patients with unstable angina and non-ST elevation myocardial infarction in associations with diabetes mellitus type 2 are characterized with increased heart rate partly resistant to β-blockers, which indicates worse prognosis of cardiovascular diseases. 2. Prescription of carvedilol in daily dose 12.5 - 25 mg. is inadequate for obtaining HR < 70 bmp. in some patients with acute coronary syndrome and diabetes mellitus. 3. According to heart rate resistance to β-blockers in patients with unstable angina and non-ST elevation myocardial infarction and concomitant diabetes mellitus patients need individual titration of higher doses of carvedilol.