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Query: UMLS:C0011849 (diabetes)
277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this study was to compare left ventricular function, assessed by radionuclide angiocardiography, in 54 diabetics and 194 non-diabetics with acute myocardial infarction (AMI). The most meaningful results concern the inferior AMI group, whose left ventricular ejection fraction (LVEF) and regional wall motion were significantly lower in diabetics than in non-diabetics (LVEF was 44.2 +/- 11 vs. 51.6 +/- 9%, P less than 0.005; the regional wall motion score was 0.46 +/- 1 vs. 1.56 +/- 1, P less than 0.01, respectively), while no significant difference was observed in the anterior AMI group. However, in the group as a whole, the LVEF was 41 +/- 13% in diabetics and 47 +/- 13% in non-diabetics (P less than 0.01), the number of abnormally contracting segments was 2.0 +/- 0.9 and 1.5 +/- 1, respectively, and the wall motion score was 0.2 +/- 1.1 and 1.0 +/- 1.4, respectively (P less than 0.01). These data could be explained by an underlying cardiac dysfunction in diabetes, in addition to AMI. The more marked difference between diabetics and non-diabetics in inferior AMI might be related to the smaller infarct size in this group.
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PMID:Radionuclide assessment of left ventricular function in patients with myocardial infarction and diabetes mellitus. 173 2

In a totally nonselected group of patients with acute myocardial infarction (AMI) (n = 921) admitted from the emergency department to the coronary care unit or other hospital ward, the occurrence of non-Q-wave AMI and the prognosis in these patients was determined and compared with those in whom Q waves were developed. Fifty-two percent had AMI without new Q waves. Patients with a non-Q-wave AMI differed from patients with Q-wave AMI, more frequently having a previous history of AMI (p less than 0.001), angina pectoris (p less than 0.01), diabetes mellitus (p less than 0.05), congestive heart failure (p less than 0.001), and a higher mean age (p less than 0.001), whereas smoking was more common in Q-wave AMI. Patients with non-Q-wave AMI had a 1-year mortality of 31% compared with 26% in Q-wave AMI (p greater than 0.2) and a reinfarction rate of 20% compared with 12% for Q-wave AMI (p less than 0.01). Among patients aged less than 75 years without a previous history of AMI, congestive heart failure, and diabetes mellitus, the 1-year mortality rate was 16% for patients with Q waves versus 15% for those without Q waves (NS). Appearance of Q waves was not independently associated with death. We conclude that in a nonselected group of patients with AMI the occurrence of a non-Q-wave AMI is much higher than previously reported. The prognosis in AMI during one year of follow-up is not associated with development of Q waves.
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PMID:Prognosis in acute myocardial infarction in relation to development of Q waves. 176 23

Consecutive patients admitted to our hospital with suspected acute myocardial infarction during 21 months were prospectively evaluated. One-year mortality after discharge from hospital was related to whether or not an infarction developed (infarct versus non-infarct patients). Of patients discharged alive after developing an infarct, there was a mortality of 17% (n = 777) versus 12% (n = 1830) (P less than 0.001) for all patients not developing infarction. In a high risk group (any of the following: age greater than or equal to 75 years, previous history of myocardial infarction, diabetes mellitus or congestive heart failure) patients developing infarction had a mortality of 24% (n = 457) versus 17% (n = 1221) for those who did not (P less than 0.001). In a low risk group (none of the high risk criteria), the corresponding mortality was 8% (n = 316) for patients suffering infarction and 3% (n = 603) for those not having infarction (P less than 0.001). The difference in mortality between patients with and without infarction was most marked in women (21% vs 11%; P less than 0.01) and in hypertensives (25% vs 12%; P less than 0.001), but less marked in men (16% vs 13%; NS) and in patients without hypertension (13% vs 12%; NS). Among patients not suffering infarction, mortality was particularly high in those with previous congestive heart failure (23%) and diabetes mellitus (21%).
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PMID:One-year mortality rate after discharge from hospital in relation to whether or not a confirmed myocardial infarction was developed. 179 Oct 91

The purpose of this study was to evaluate the clinical characteristics and the factors related to early mortality in the acute myocardial infarction of the geriatric population. We studied 814 consecutive patients with their first acute myocardial infarction admitted to the coronary care unit at tha Hospital General de Galicia. 401 patients were older than 65 years (Group A) and 413 were younger (Group B). Group A was found a significantly lower percentage of males (64.7% versus 88.4%; p less than 0.001) and smokers (46.7% versus 72.7%; p less than 0.001; and older patients showed a greater incidence of diabetes mellitus (28.1% versus 15.2%; p less than 0.001) and arterial hypertension (45.6% versus 31.7%; p less than 0.01). In the geriatric population, the clinical course of the acute myocardial infarction is characterized by a greater incidence of heart failure (35.3% versus 11.1%; p less than 0.001), cardiogenic shock (18% versus 5.7%; p less than 0.001) and post-acute myocardial infarction angina pectoris (18.3% versus 12.2%; p less than 0.05). Early mortality (first month) was significantly higher in elderly patients (22.7% versus 6.3%; p less than 0.001). The multivariate analysis by stepwise logistic regression identified cardiogenic shock, age and heart failure as the only independent predictive variables for early mortality. We conclude that early mortality in the acute myocardial infarction is high and related to severe degrees of pump failure and age.
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PMID:[Clinical and prognostic implications of age in acute myocardial infarct]. 179 10

The authors examined 68 patients with a acute myocardial infarction without previously detected diabetes. They evaluated some indicators of the humoral stress response and the response of the carbohydrate metabolism during a recent infarction. They found very complicated interrelations between hormones of the stress reaction and indicators of the carbohydrate metabolism under conditions of circulatory stress. Despite this they detected some dominating trend and compared their findings with data from the literature.
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PMID:[The carbohydrate metabolism and stress hormone response during acute myocardial infarct in persons without diagnosed diabetes]. 179 59

The authors examined 68 patients with a acute myocardial infarction without previously detected diabetes. They evaluated the importance of the relationship of the intensity of the stressor, humoral stress response and the response of the carbohydrate metabolism for the early prognosis of the infarction. Despite the complexity of these relations and heterogenity in the group of these patients, the authors confirmed the prognostic importance of hyperglycaemia, cortisolaemia and urinary catecholamine levels, and based on their own experience, they recommended to follow up these indicators during the first days after development of the infarction.
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PMID:[The value of the carbohydrate metabolism response for assessment of early prognosis in patients with acute myocardial infarct without previously detected diabetes]. 179 58

The authors examined in a group of 68 patients with a acute myocardial infarction (without confirmed diabetes) some indicators of the humoral stress reaction and the response of indicators of the carbohydrate metabolism during circulatory stress. After three years they re-examined 48 of these patients with special attention to their carbohydrate metabolism. Based on the assembled results, the authors sought a relationship between findings during the acute circulatory stress and the level of the carbohydrate metabolism after three years. In future diabetics they found during the period of the acute infarction higher levels of immunoreactive insulin, a reduced IRI/blood sugar ratio and a higher excretion of urinary catecholamines. In the OGTT performed one week after the infarction they found a higher sum of C-peptide, a shift of the peak of IRI secretion and reduced IRI/blood sugar ratio. These finding could indicate the development of a permanently impaired glycoregulation and lang-term prognosis of these patients.
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PMID:[The carbohydrate metabolism and stress hormone response in acute myocardial infarct--its importance in predicting permanent disorders of glucoregulation]. 179 60

To evaluate the prevalence and prognostic significance of hyperglycemia in acute myocardial infarction, we studied 700 patients (mean age 63.3 +/- 10.97) subsequently admitted to the UCIC of Tradate Hospital during the period January 1976 to December 1987. Patients were followed up for a median period of four years. On the basis of fasting blood glycaemia values in the first five days of hospitalization, excluding the admission day, patients were divided into groups: 401 patients (57.0%) with constantly normal glycaemia; 84 patients (12.0%) with glycaemia equal or superior to 120 mg/100 ml, and with subsequent normalization; and 215 patients (31.0%) with diabetes mellitus diagnosed before hospitalization and/or with persistent hyperglycaemia. The overall mortality was 284 (40.5%) and cardiovascular deaths were 90.8%. Within the first month of myocardial infarction 98 patients died. The mortality rate was 9.4% in normoglycaemic patients and 20.2% in transient hyperglycaemic patients, similar to the value observed in diabetic patients (20.0%). During the follow-up 186 patients died. Late mortality after the first month is higher in diabetic patients (40%) and patients with transient hyperglycaemia (37%) compared to normoglycaemic patients (25.3%). Multivariate analysis shows that independent predictive variables are: for mortality in the first month, Killip class only; and after the first month, Killip class, metabolic classification, sex and supraventricular arrhythmias. The present study shows that transient hyperglycaemia has a low prevalence in the first days of acute myocardial infarction. Transient hyperglycaemia could be attributed not only to increased sympathetic tone elicited by acute myocardial infarction, but is probably a pathologic condition with an adverse outcome to which multiple factors contribute.
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PMID:[Transient hyperglycemia in acute myocardial infarct: the short- and long-term risk factor for mortality]. 180 42

We report cases of angina pectoris or minimal acute myocardial infarction accompanied by pulmonary edema, which were retrospectively studied with regard to their clinical characteristics, prognosis and treatment. Sixteen patients, 5 males and 11 females with a mean age of 72.6 years, admitted to the Cardiovascular Center of Sendai between January 1986 and June 1989, were studied. Ten had previous myocardial infarction. Hypertension, chronic renal failure and diabetes mellitus were found in 10, 7 and 7 patients, respectively. Electrocardiograms during cardiac ischemic attacks showed ST elevation in 8 and ST depression in the other 8 patients. Coronary arteriography which was performed in 6 patients revealed three-vessel disease in 5, and two-vessel disease in one. Mechanical ventilation was indicative of 7, and intraaortic balloon counterpulsation in 2 patients. Coronary artery bypass graft surgery was performed for 3 patients. All patients recovered from pulmonary edema and were discharged. During the mean 15-month-follow-up period, 8 patients died. The causes of death were sudden cardiac death in 3, acute myocardial infarction in one, congestive heart failure in one, post-surgical death in one, and non-cardiac death in 2.
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PMID:[Pulmonary edema caused by cardiac ischemic attacks in cases with or without minimal myocardial infarction]. 184 32

In 28 patients with first myocardial infarction plasma catecholamines and thrombocyte alpha 2-adrenoceptors were studied. The first determination (by HPLC and radioligand binding, respectively) was performed immediately after hospital admission and 6 weeks later. In the acute phase of myocardial infarction plasma adrenaline and noradrenaline levels were high. No significant differences in thrombocyte alpha 2-adrenoceptors and plasma concentrations of adrenaline and noradrenaline were observed between diabetic and non-diabetic patients. In three non-surviving patients only the affinity of the alpha 2-adrenoceptor to the radioligand was decreased (P less than 0.05), the relatively high catecholamine levels failed to reach statistical significance. Six weeks after hospital admission, adrenaline plasma levels were significantly decreased in diabetic and non-diabetic patients, while noradrenaline was only lowered in non-diabetic patients (P less than 0.05). Only in this group did the receptor number (BMAX) show a significant elevation 6 weeks after hospital admission. We conclude that, in acute myocardial infarction, alpha 2-adrenoceptors mainly interact with noradrenaline. Accordingly, no adrenoceptor alteration occurred in diabetic patients, who showed only a decrease in adrenaline but not in noradrenaline plasma concentrations 6 weeks following myocardial infarction. The different patterns in diabetic and non-diabetic patients suggest an alteration of catecholamine metabolism in diabetes mellitus.
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PMID:Catecholamines and thrombocyte alpha 2-adrenoceptors in patients with acute myocardial infarction. 184 82


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