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Comparison of secondary prevention measures after myocardial infarction in subjects with and without diabetes mellitus
Author(s) -
Chowdhury T. A.,
Lasker S. S.,
Dyer P. H.
Publication year - 1999
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1046/j.1365-2796.1999.00473.x
Subject(s) - medicine , diabetes mellitus , aspirin , myocardial infarction , blood pressure , cholesterol , cohort , cardiology , endocrinology
. Chowdhury TA, Lasker SS, Dyer PH (Birmingham Heartlands Hospital, Birmingham UK). Comparison of secondary prevention measures after myocardial infarction in subjects with and without diabetes mellitus. J Intern Med 1999; 245: 565–570. 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. 61.0%). 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.