IMPACT OF TYPE 2 DIABETES MELLITUS ON CLINICAL AND FUNCTIONAL FEATURES AND PROGNOSIS IN PATIENTS WITH ACUTE CORONARY SYNDROME

Aim. Was to evaluate impact of type 2 diabetes mellitus (T2DM) on clinical and functional characteristics and prognostic parameters in patients with acute coronary syndrome (ACS). Materials and Methods. We examined 251 patients aged 50-75 years, 119 men and 132 women, who admitted to the coronary care unit with ACS. These patients were divided into two groups. The first group included patients with ACS and T2DM. The second group included patients without T2DM. Evaluation of patients included general clinical investigations, laboratory tests, coronary angiography, echocardiography, Holter monitoring. Frequency of myocardial revascularization, myocardial infarction and death in 12 months of follow-up was analyzed. Results. Incidence of previous myocardial infarction, stroke, peripheral arterial disease and obesity was higher in the group of patients with ACS and T2DM. In patients with T2DM multivessel coronary artery disease was more common (p=0,001). In the acute period coronary artery bypass grafting was performed more often in patients with T2DM (p=0,03). According to echocardiography the most common left ventricular myocardial remodeling in patients with T2DM was concentric hypertrophy (p=0,002). According to the results of Holter monitoring heart rate variability was decreased more significant in patients with diabetes. Patients with ACS and T2DM underwent myocardial revascularization more frequently during 12 months of follow-up compared with patients without diabetes (p=0,007). Conclusions. According to our data T2DM increases frequency of myocardial revascularization during 12 months after ACS.