Diabetes mellitus worsens the prognosis of an acute myocardial infarction in patients older than 80 years

Objective

To evaluate the influence of diabetes mellitus in the prognosis of an acute myocardial infarction in patients older than 80 years.

Methods

This was a retrospective analysis. We studied a period of time of 10 years (from 1 July 1989 to 30 June 1999). Analyzed were all patients older than 80 years admitted with an acute myocardial infarction. The statistical analysis was realized by Chi-square test. Values P < 0.05 were considered statistically significant.

Results

Analyzed were 235 patients (51.06% males) and 26.38% had diabetes mellitus. They had the following pathological antecedents: arterial hypertension 39.14%, coronary disease 34.04%. Myocardial infarction was anterior in 69.78% cases and 80.85% patients developed Q wave. Patients had several complications: 14.04% supraventricular tachycardia, 5.95% complete atrioventricular block, 59.14% left ventricular failure, 34.89% cardiogenic shock and dead 39.14%. Patients with diabetes mellitus developed more left ventricular failure (67.74% vs 53.17%), cardiogenic shock (46.77% vs 32.36%) and had more incidence of exitus (50% vs 35.26%). We did not find significant differences in the sex, antecedents of arterial hypertension, antecedents of coronary disease, localization of myocardial infarction and development of Q wave. Neither were significant differences noted in the appearance of supraventricular tachycardia and complete atrioventricular block.

Conclusions

Diabetes mellitus had a negative influence in the evolution of an acute myocardial infarction in patients older than 80 years.