Clinical and medical history features of acute myocardial infarction in patients with diabetes mellitus. Epidemiology study

The aim of the present study was to investigate clinical and medical history features of the onset, course, and short-term outcomes of acute myocardial infarction (AMI) in patients with type 2 diabetes mellitus (T2DM). Original data were obtained from analytical information database of the World Health Organization epidemiology program “Acute Myocardial Infarction Register” for 2014 to 2015. A total of 1157 cases of AMI, registered in Tomsk in 2014-2015 except prehospital death episodes, were analyzed. Type 2 diabetes mellitus was present in medical history of 259 (22.4%) patients with AMI. Age-gender structure of patients with diabetes mellitus showed that women (60.2% and 35.4%, respectively; p<0.001) and individuals older than 60 years (76.1% and 57.8%, respectively; p<0.001) prevailed. Obtained results demonstrated that AMI in the presence of T2DM was characterized with more severe cardiovascular medical history, severe AMI course with frequent atypical onset, a few electrocardiographic findings, and very high lethality. The vast majority of fatal AMI cases were registered when patients were in general hospitals. The presence of significant number of women and older individuals among T2DM patients as well as high frequency of cases with atypical clinical onset of the disease and complicated medical history hampered AMI diagnosis. All above-said suggests the necessity of increase awareness of physicians working in general hospitals and emergency departments in regard to individuals with T2DM as potentially vulnerable to AMI development.