Diabetes and heart attack is a particularly risky combination
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Diabetes is a growing public health concern. High blood sugar
levels slowly attack the artery walls and facilitate deposits of cholesterol.
The ensuing lipid-rich plaques can block arteries in the heart, brain, and
legs, raising the risks of heart attack, stroke, and claudication with possible
amputation.
In theory, high blood glucose levels may impair the capacity
of heart cells to contract and propel blood throughout the body, leading to
heart failure. However, whether patients with diabetes are at greater risk of
developing heart failure when suffering a heart attack has not been extensively
studied.
The study used data from nationwide surveys carried out in
France between 2005 and 2015 in 12,660 patients hospitalised for a heart
attack. The researchers analysed whether diabetic patients were more likely
than non-diabetic patients to develop heart failure during their hospital stay
and in the year after. In patients with diabetes, they compared five-year
mortality in those readmitted for nonfatal heart failure during the year
following their heart attack versus those who did not develop heart failure.
Nearly 25% of patients hospitalised for an acute myocardial
infarction during the ten-year period had known diabetes (3,114 of 12,660
patients). “This figure is consistent with what most cardiologists have found
among their heart attack patients and illustrates how common diabetes is,” said
Prof Danchin.
During hospitalisation for myocardial infarction, 32% of
patients with diabetes developed heart failure compared to 17% of patients
without diabetes. After adjusting for other factors that could cause heart
failure, those with diabetes had a 56% higher risk than those without of
developing heart failure.
Likewise, in those who survived the heart attack, 5.1% of
diabetic patients were hospitalised for nonfatal heart failure in the following
year compared to 1.8% of non-diabetic patients. After adjustment, this equated
to a 44% raised risk of heart failure in those with diabetes.
Finally, among patients with diabetes who were alive one year
after their heart attack, 56% of patients who had been hospitalised for heart
failure during that year died during the subsequent four years compared to 21%
of those without heart failure. After adjustment, this amounted to a 73% higher
risk of five-year mortality in those with heart failure. The increased risk was
particularly marked for diabetic patients requiring insulin.
Prof Danchin said: “Our study shows that diabetes is
associated with a considerably increased risk of developing heart failure after
a heart attack. Furthermore, diabetic patients who develop heart failure in the
year after a heart attack have a much higher risk of dying in the following
years.”
He concluded: “More efforts are needed to prevent diabetes.
In addition, better management is required for diabetic patients who have a
heart attack to avoid heart failure and its detrimental long-term
consequences.”
Click on this link more details: https://diabetes-heart-disease.healthconferences.org/
Submit your abstract: https://diabetes-heart-disease.healthconferences.org/abstract-submission.php
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