Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixty patients with diabetes mellitus who survived the coronary care unit phase of acute myocardial infarction (AMI) were followed an average of 19 months and the prognosis of diabetic patients was compared with that of 719 nondiabetic patients. The mortality rate was 25% in diabetic patients and 8% in nondiabetic patients. These patients had been entered in a Multicenter Postinfarction Program, where analysis of the total data base showed 4 significant prognostic factors: cardiac symptoms before AMI, pulmonary rales when the patient was in the coronary care unit, more than 10 ventricular premature complexes per hour recorded on Holter monitor just before discharge, and a radionuclide ejection fraction of less than 40%. Of these 4 factors, only cardiac symptoms before AMI was significantly more common in diabetic patients (57% in diabetic vs 36% in nondiabetic patients). When each of these 4 factors was stratified for severity, the mortality rate was always higher in diabetic patients. The data were examined to determine other factors in diabetic patients who died. Pulmonary rales was significantly more common in diabetic patients who died (6% in survivors vs 42% in patients who died). In a multivariate analysis of both diabetic and nondiabetic patients, 5 factors were significant determinants of prognosis. They are, in order of entry into the model, rales (p less than 0.001), ejection fraction less than 40% (p less than 0.001), diabetes (p less than 0.001), symptoms before AMI (p = 0.009), and more than 10 ventricular premature complexes per hour (p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Prognosis of patients with diabetes mellitus after acute myocardial infarction. 638 80

Elderly persons after myocardial infarction should have their modifiable coronary artery risk factors intensively treated. Hypertension should be treated with beta blockers and angiotensin-converting enzyme inhibitors. The blood pressure should be reduced to <140/85 mmHg and to > or = 130/80 mmHg in persons with diabetes or renal insufficiency. The serum low-density lipoprotein cholesterol should be reduced to <100 mg/dl with statins if necessary. Aspirin or clopidogrel, beta blockers, and angiotensin-converting enzyme inhibitors should be given indefinitely unless contraindications exist to the use of these drugs. Long-acting nitrates are effective antianginal and antiischemic drugs. There are no Class I indications for the use of calcium channel blockers after myocardial infarction. Postinfarction patients should not receive Class I antiarrhythmic drugs, sotalol, or amiodarone. An automatic implantable cardioverter-defibrillator should be implanted in postinfarction patients at very high risk for sudden cardiac death. Hormonal therapy should not be used in postmenopausal women after myocardial infarction. The two indications for coronary revascularization are prolongation of life and relief of unacceptable symptoms despite optimal medical management.
 ...
PMID:Management of the elderly person after myocardial infarction. 1560 72

Persons after myocardial infarction (MI) should have their modifiable coronary artery risk factors intensively treated. Hypertension should be treated with beta blockers and angiotensin-converting enzyme (ACE) inhibitors. The blood pressure should be reduced to <140/90 mmHg and to <130/80 mmHg in persons with diabetes or renal insufficiency. The serum low-density lipoprotein cholesterol should be reduced to <70 mg/dl with statins if necessary. Diabetics should have their hemoglobin A1c reduced to <7.0%. Aspirin or clopidogrel, beta blockers, and ACE inhibitors should be given indefinitely unless contraindications exist to the use of these drugs. Long-acting nitrates are effective antianginal and antiischemic drugs. Postinfarction patients at very high risk for sudden cardiac death should have an implantable cardioverter-defibrillator. The two indications for coronary revascularization are prolongation of life and relief of unacceptable symptoms despite optimal medical management.
 ...
PMID:Treatment after myocardial infarction. 1798 93

After an MI, elderly persons should have their modifiable coronary artery risk factors--such as hypertension, dyslipidemia, and diabetes--intensively treated. Aspirin or clopidogrel, beta-blockers, and ACE inhibitors should be given indefinitely, unless contraindications exist. Long-acting nitrates are effective antianginal and anti-ischemic drugs. There are no Class I indications for the use of calcium channel blockers after MI. Postinfarction patients should not receive Class I antiarrhythmic drugs, sotalol, or amiodarone. Those at very high risk for sudden cardiac death should have an implantable cardioverter-defibrillator. Hormonal therapy should not be used in postmenopausal women after MI. The indications for coronary revascularization are prolongation of life and relief of unacceptable symptoms despite optimal medical management.
 ...
PMID:Optimal medical therapy after MI in the elderly. 1825 17

Cardiomyocyte energy metabolism in experimental unfolding postinfarction cardiosclerosis and diabetes mellitus was studied. Postinfarction cardiosclerosis formed 6 weeks after coronary artery occlusion. Diabetes mellitus was induced by intraperitoneal injection of streptozotocin (60 mg/kg). The rate of oxygen consumption in postinfarction cardiosclerosis and diabetes increased by 3.4 and 4.2 times, respectively. Stimulation of mitochondrial respiration (ATP, palmitic acid) significantly increased oxygen consumption in animals with postinfarction cardiosclerosis and significantly reduced this process in diabetes. The content of LDH and SDH in the myocardium of animals with diabetes and postinfarction cardiosclerosis was significantly below the control. Hence, the development of postinfarction cardiosclerosis and diabetes mellitus were characterized by reduced generation of ATP in anaerobic and aerobic pathways and oxidative phosphorylation in cardiomyocytes.
...
PMID:Comparative study of changes in energy metabolism in rat cardiomyocytes in postinfarction cardiosclerosis and diabetes mellitus. 2431 44

We studied the expression of Ca(2+)-ATPase in sarcoplasmic reticulum of rat cardiomyocytes during isolated and combined development of postinfarction cardiosclerosis and diabetes mellitus. Postinfarction cardiosclerosis was formed within 6 weeks after coronary artery occlusion. Diabetes mellitus developed within 6 weeks after intraperitoneal injection of streptozotocin (60 mg/kg). Ca(2+)-ATPase in homogenate of rat myocardium was assayed by immunoblotting. Ischemic and diabetic remodeling of the myocardium was associated with reduced expression of Ca(2+)-ATPase in the sarcoplasmic reticulum. Combined pathology was characterized by minimum decrease in the level of this protein. It was concluded that induction of diabetes mellitus at the early stage of postinfarction cardiosclerosis triggered adaptive mechanisms that prevent the decrease in Ca(2+)-ATPase level in the sarcoplasmic reticulum of cardiomyocytes.
...
PMID:Expression of Ca(2+)-ATPase in sarcoplasmic reticulum in rat cardiomyocytes during experimental postinfarction cardiosclerosis and diabetes mellitus. 2482 87