Factors associated with cardiac arrhythmias in patients with type 2 diabetes mellitus and myocardial infarction
Panova, E.I.; Kruglova, N.E.
Klinicheskaia Meditsina 86(1): 23-26
2008
ISSN/ISBN: 0023-2149 PMID: 18326278 Document Number: 619632
An analysis of some features of heart arrhythmias in patients with myocardial infarction (MI) and type 2 diabetes mellitus (DM2) was performed. The study revealed that arrhythmias (usually extrasystoles or atrial fibrillation) were more common in patients with DM type 2 (42.1% in DM2, and 30.4% in non-DM patients, p = 0.0041) and demonstrated a direct correlation with coronary and myocardial dysfunction. In patients with DM2, arrhythmias were associated with the duration of DM and HbA1c level. In severe metabolic decompensation (HbA1c > 8.5%) and in cases with a relatively low HbA1c level (< 7%) arrhythmias were more frequent than in patients with an HbA1c level between 7.0% and 8.5%. In patients with an HbA1c level < 7.0%, the threat of hypoglycemia is increased, often due to insulinotherapy, as a possible arrhythmogenic factor associated with a relative elevation of immunoreactive insulin and C-peptide and diabetic nephropathy (DN). Severe DM decompensation (HbA1c > 8.5%) was associated with metabolic disturbances and toxic effect of hyperglycemia. Cardiac arrhythmias, systolic dysfunction, and DN are prognostically unfavorable factors influencing the survival rate in patients with MI and DM2.