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

A group of 102 patients (66 males, age 62 +/- 11 years) surviving an acute myocardial infarction was followed for 6 to 48 months. Survival was analyzed by the method of Kaplan Meier and Cox analysis was used to identify prognostic factors. Thirteen patients died during follow up: 3 had sudden death, 3 a stroke, 3 died from heart failure, 3 had reinfarction and cardiogenic shock and 1 died from cholangitis. Most deaths occurred in the first few months of follow up. Survival was 92% at 6 months, 90% at 1 year, 88% at 2 years and 86% at 3 years after infarction. Single variable analysis disclosed a 2 to 3 fold late mortality risk associated to the presence of age over 60 years, old myocardial infarction, hypertension, diabetes mellitus and ventricular tachycardia or fibrillation during the acute phase. Greater than 3 fold risk was seen for patients developing heart failure or shock during myocardial infarction. Heart failure was the only statistically significant risk factor identified by multivariate analysis.
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PMID:[Prognosis after myocardial infarction]. 213 24

The atherosclerotic process in the diabetic patient, is more common, it is noticed at early ages, advances more rapidly and almost equally affects males and females. This data, can not be explained on the basis of the association with other coronary heart disease risk factors, there is an intrinsic atherogenic factor attributed to diabetes, and can be related, to the early hyperinsulinemia, coagulation and lipid disorders, hyperglycemia or diabetic microangiopathy. Coronary heart disease has an increased prevalence in diabetic patients, that is not related with diabetes duration or the type of treatment. Early and late morbimortality after acute myocardial infarction and/or revascularization surgery is twice as common in the diabetic patient. Diabetic cardiomyopathy related to small vessels disease is still a matter of controversy and many authors doubt about its relevance in clinical practice. The presence of autonomic neuropathy with the cardiovascular denervation syndrome carries a poor prognosis. Early cardiovascular changes in asymptomatic patients, are detected with non-invasive test, and can help to introduce measures to protect individuals at a greater risk.
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PMID:[The heart and diabetes mellitus]. 218 26

Authors treated and checked 474 patients with acute myocardial infarction (AMI) during 5 years. The occurrence of hypertension was 37.15% of the total number of patients but this rate was 51.37% for women patients. Obesity, hyperlipidaemia and diabetes mellitus were the most frequent of the risk factors on the patients with hypertension. Asthma cardiale and acute arrhythmias were slightly more frequent early complications and cardial decompensation was a slightly more frequent late complication. The number of myocardial reinfarctions was the same both in the case of hypertensive and normotensive patients under the circumstances of parallel normalization and keeping the tension and serum cholesterol on the normal level.
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PMID:[Incidence and role of hypertension in the development and recurrence of acute myocardial infarct in a 5-year case load]. 218 98

Recent documentation of a circadian variation in acute myocardial infarction (AMI) suggests that AMI is not a random event, but may frequently result from identifiable triggering activities. The possible triggers reported by 849 patients enrolled in the Multicenter Investigation of Limitation of Infarct Size were analyzed. Possible triggers were identified by 48.5% of the population; the most common were emotional upset (18.4%) and moderate physical activity (14.1%). Multiple possible triggers were reported by 13% of the population. Younger patients, men and those without diabetes mellitus were more likely to report a possible trigger than were older patients, women and those with diabetes. The likelihood of reporting a trigger was not affected by infarct size. This study suggests that potentially identifiable triggers may play an important role in AMI. Because potential triggering activities are common in persons with coronary artery disease, yet infrequently result in AMI, further studies are needed to identify (1) the circumstances in which a potential trigger may cause an event, (2) the specific nature of potential triggering activites, (3) the frequency of such activities in individuals who do not develop AMI and (4) the presence or absence of identifiable triggers in various subgroups of patients with infarction.
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PMID:Analysis of possible triggers of acute myocardial infarction (the MILIS study). 219 95

Part I of this article, which appeared in the previous issue of the Journal, discussed the implications of variations in plasma protein levels in a number of diseases: hepatic and renal disease, acute myocardial infarction, burns, cancer, diabetes mellitus, hyperlipidaemia and inflammatory diseases. In Part II the authors continue their review with a further range of disease states, and consider their import for drug dosages.
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PMID:Disease-induced variations in plasma protein levels. Implications for drug dosage regimens (Part II). 220 81

Careful consideration of all relevant scientific evidence and a critical assessment of data quality show that thiazide diuretics are not cardiotoxic. Of 12 reported trials only two recorded more coronary heart disease events in thiazide-treated patients than in controls. One of these two was a subgroup of a larger study (Heart Attack Prevention in Primary Hypertension, HAPPHY) which found no difference between thiazide-treated and beta-blocker-treated patients. The other, the Oslo study, was too small to allow valid conclusions. Results from a subgroup in the Multiple Risk Factor Intervention Trial (MRFIT) that appeared to supply evidence for thiazide-related cardiotoxicity are suspect when examined critically. Further evidence from 24- to 28-h ECG monitoring does not support the hypothesis that thiazide diuretics, either in the presence or absence of hypokalemia, increase the frequency or severity of ventricular arrhythmias. Reports of a thiazide-induced intracellular magnesium deficiency as a cause of ventricular arrhythmias have also not been confirmed; the development of arrhythmias in acute myocardial infarction appears to be due to an increase in catecholamine levels rather than hypokalemia. There appears to be little evidence to support the assumption that long-term use of thiazide diuretics aggravates or accelerates atherosclerosis of the coronary arteries; any fall in serum cholesterol appears to be transient. For the great majority of patients with uncomplicated hypertension, without a previous myocardial infarction, congestive heart failure, diabetes mellitus or gout, thiazide diuretics appear to be both safe and effective antihypertensive agents.
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PMID:The cardiotoxicity of thiazide diuretics: review of the evidence. 221 84

A variety of experimental studies suggest that diastolic left ventricular (LV) function changes after acute myocardial infarction (AMI), but limited data exist on these changes in humans. To assess diastolic filling after AMI, 60 patients underwent Doppler echocardiographic examination within 24 hours of AMI. Of 54 patients who also underwent catheterization, 45 (83%) were successfully reperfused. A subgroup of 17 patients underwent a follow-up Doppler examination at 7 days after infarction, whereas 15 patients with stable exertional angina served as control subjects. There was no significant difference in age, gender, incidence of systemic hypertension or diabetes mellitus, heart rate, mean arterial pressure or severity of coronary artery disease between the infarct and control groups. The infarct group had a lower velocity time integral total (9.9 +/- 0.4 cm vs 12.0 +/- 0.9 cm, p less than 0.001), a lower velocity time integral E (5.8 +/- 0.3 cm vs 6.8 +/- 0.5 cm, p less than 0.01) and a lower velocity time integral 0.333 (3.5 +/- 0.4 cm vs 6.1 +/- 0.5 cm, p less than 0.01) than the control group. In addition, velocity time integral A/total was significantly greater in the infarction group (0.44 +/- 0.03 vs 0.35 +/- 0.04, p less than 0.01) compared to the control group. The follow-up subgroup showed an increase in velocity time integral total (p less than 0.01), velocity time integral E (p less than 0.05) and velocity time integral 0.333/total (p less than 0.05) over the first 7 days after infarction. The final recovery values at 7 days were not significantly different from those of the coronary artery disease group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Transient left ventricular filling abnormalities (diastolic stunning) after acute myocardial infarction. 222 Jun 12

Superoxide dismutases (SOD) and their changes in diabetes, aging, ischemia and cancer were studied, Cu, Zn-SOD undergoes glycation reaction in vitro and in vivo and loses its activity by formation of Amadori compounds. Two lysine residues of Cu, Zn-SOD, Lys-122 and Lys-128 are primary glycated sites which are located on the surface of the molecule. The sites are also located on the active site liganding loop which plays a major role in the activity. The glycated Cu, Zn-SOD increased in the red cells of diabetic patients, especially those with diabetic complications. Mn-SOD appears in the serum of patients with acute myocardial infarction in a biphasic manner. The enzyme appears in sera 16 hr and 108 hr after the attack as determined by ELISA. The Mn-SOD levels are also increased in the serum of patients with epithelial ovarian cancer and it is a good marker for detecting and monitoring this cancer. Mn-SOD may play an important role in the ischemic and cancer tissues.
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PMID:[Superoxide dismutases: significances in aging, diabetes, ischemia and cancer]. 223 47

To evaluate characteristics of coronary atherosclerosis in older patients and to elucidate the role of dipyridamole myocardial perfusion scintigraphy (DMPS) in the assessment of patients with coronary artery disease, 437 patients (330 men, 107 women, age range 13-85 years) initially underwent coronary angiography (CAG) and DMPS. Coronary risk factors were evaluated in relation to the severity and progression of coronary atherosclerosis. Cardiac events were also evaluated during the follow-up period of 39 +/- 19 months (range 1-77 months). Assessment of five coronary risk factors, including hypercholesterolemia, diabetes, hypertension, positive family history, and history of smoking, was made in 212 patients in relation to the severity of coronary atherosclerosis. In patients with insignificant lesions or single vessel disease, prevalence of hypercholesterolemia and positive family history was lower in older patients (65 years or older) than in younger patients (64 years or younger), but significant difference was not found in prevalence of diabetes, hypertension, and history of smoking. In patients with multivessel disease, there was no significant difference in prevalence of coronary risk factors between the two groups except history of smoking. Repeated CAG was performed in 27 patients during follow-up. Nineteen of them experienced increased symptoms of angina and eight patients newly developed acute myocardial infarction. The patients with increased angina had more risk factors, and majority of them (74%) showed some progression of previously noted severe stenoses in the proximal coronary arteries. In patients with new infarction, 62% of them showed new total occlusions as infarct-related lesions, although there were some patients who showed progression of previously noted severe lesions. DMPS was performed in 437 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Progression of coronary atherosclerosis and the non-invasive evaluation in older patients]. 223 11

The rupture of the heart wall is a severe complication of the acute myocardial infarction. We found it in 3.5% of the deceased patients with an acute myocardial infarction. The average age of these patients was 71 years. 75% of the patients died during the first five days after the event of the myocardial infarction. Apart from elderly patients with myocardial infarction such ones with a transmural myocardial infarction in the region of the left ventricle, an enlargement of the heart and signs of an insufficiency of the left heart, with a hypertension and diabetes mellitus seemed to be endangered. These patients need the most exact control and observation and in case of suspicion (symptomatology of angina pectoris which is continuing to exist) of a developing rupture of the heart wall and aimed diagnostics (echocardiography) and therapy must be begun immediately.
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PMID:[Heart wall rupture as a grave complication of acute myocardial infarct]. 223 50


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