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Original Article

IJMDC. 2020; 4(3): 620-628

Myocardial infarction risk factors and outcome among diabetic and nondiabetic patients at the high altitude of Saudi Arabia

Walaa A Aldarwish, Ali A Alqarni, Abdulrahman A Medawi, Afnan Z Alhwaishel, Amani H AbuHassan, Baqer A. Aldarwish.

Background: Diabetes mellitus is linked strongly with the development of coronary artery disease, and therefore, early prevention is more required among diabetics. The diabetic patient needs special care and observation with a view to the prevention, control, and treatment of the various manifestations of coronary artery disease. This study aims to assess the differences in myocardial infarction (MI) risk factor distribution and in hospital outcome among diabetic and nondiabetic patients.
Methodology: A prospective observational study was conducted on a selected sample of patients with MI who are admitted in the Cardiac Department at Aseer Central Hospital from 1st June to 30th December 2017. Data were collected from the medical record, and the patients were followed up to find the outcomes and complications.
Results: Among a total of 306 subjects included (203 diabetics and 103 nondiabetics), with the ages of 20-85 years, males were 76.1% and females were 23.9%. Among the diabetic groups, 49.3% were diagnosed as ST-segment elevated MI. Non ST-segment elevated MI was diagnosed in 21.7% of diabetics, whereas the rest 29.1% had unstable angina. The obesity was recorded among 84.2% of diabetics compared to 75.7% of nondiabetics (p = 0.014). Hypertension was recorded among 77.8% of diabetics compared to 42.7% of nondiabetics (p = 0.001). The MI complications, atrial fibrillation, and arrhythmia were higher among diabetic groups (22.2% vs. 26.6%) compared to nondiabetics (3.9% vs. 5.8%). The death rate was higher among diabetic patients with coronary artery disease than among nondiabetics (6.4% vs. 1%).
Conclusion: Diabetic patients with MI had a greater prevalence of cardiometabolic risk factors (obesity, abdominal obesity, and hypertension) as compared to nondiabetic patients. The inhospital outcome was worse among diabetic patients.

Key words: MI, DM, acute coronary syndrome (ACS), risk factors, cardiac outcome, Saudi Arabia

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