rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2015-11-5-477-482rpcardio-320Research ArticleORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯFeatures of the in-hospital course of myocardial infarction in patients with glucose metabolism disordersОСОБЕННОСТИ ГОСПИТАЛЬНОГО ТЕЧЕНИЯ ИНФАРКТА МИОКАРДА У БОЛЬНЫХ С НАРУШЕНИЯМИ УГЛЕВОДНОГО ОБМЕНАМардановБ. У.MardanovB. U.

к.м.н., с.н.с. лаборатории по разработке междисциплинарного подхода в профилактике хронических неинфекционных заболеваний отдела профилактики коморбидных состояний ГНИЦ ПМ

mb_sky@inbox.ruМамедовМ. Н.MamedovM. N.

д.м.н, профессор, руководитель лаборатории по разработке междисциплинарного подхода в профилактике хронических неинфекционных заболеваний отдела профилактики коморбидных состояний ГНИЦ ПМ

КорнееваМ. Н.KorneevaM. N.

к.м.н., м.н.с. лаборатории по разработке междисциплинарного подхода в профилактике хронических неинфекционных заболеваний отдела профилактики коморбидных состояний ГНИЦ ПМ

ОгановР. Г.OganovR. G.

д.м.н., профессор, руководитель отдела профилактики коморбидных состояний ГНИЦ ПМ

Государственный научно-исследовательский центр профилактической медицины 101000, Москва, Петроверигский пер., 10РоссияState Research Centre for Preventive Medicine. Petroverigsky per. 10, Moscow, 101990 RussiaRussian Federation201503112015115477482Copyright © Mardanov B.U., Mamedov M.N., Korneeva M.N., Oganov R.G., 20152015Марданов Б.У., Мамедов М.Н., Корнеева М.Н., Оганов Р.Г.Mardanov B.U., Mamedov M.N., Korneeva M.N., Oganov R.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/320Aim

Aim. To study the clinical course of acute myocardial infarction (MI) with ST segment elevation (STEMI) and the features of inpatient treatment in patients with and without diabetes mellitus (DM). Material and methods. STEMI patients (n=83), who were hospitalized in 2014, were included into the study. The patients were divided into two groups according to the presence or absence of glucose metabolism disorders: Group 1 (patients with type 2 DM; n=38) and Group 2 (patients without glucose metabolism disorders; n=45). Baseline demographic, clinical, laboratory and instrumental characteristics of the patients, along with the features of hospital treatment, were studied. 

Results

Results. In group 1 compared with group 2 hypertension was detected significantly more frequently (73.7% vs 49%; p<0.05), and a class of acute heart failure (Killip) at admission was higher (1.46±0.6 vs 1.23±0.57; p<0.05). STEMI was complicated by an acute left ventricular aneurysm 12% more often in patients of group 1 (p<0.05). The duration of inpatient treatment was also higher in patients of group 1 (18±4.1 vs 16±3.6 days; p<0.05). Conclusion. Only 21% of the patients with DM and STEMI had adequate treatment of ischemic heart disease and a quarter of the patients in this group had no adequate DM therapy before the admission. Patients with DM had a higher incidence of in-hospital STEMI complications and a higher duration of inpatient treatment. 

Цель

Цель. Изучить клиническое течение острого инфаркта миокарда (ИМ) с подъемом сегмента ST (ИМпST) и особенности стационарного лечения у больных с сахарным диабетом (СД) и без него. Материал и методы. Включены 83 пациента с ИМпST, госпитализированных в 2014 г. Пациенты разделены на две группы в зависимости от наличия или отсутствия нарушений углеводного обмена: 1 группа (пациенты с СД 2 типа; n=38) и 2 группа (пациенты без нарушений углеводного обмена; n=45). Изучали исходные клинико-демографические и лабораторно-инструментальные характеристики больных, а также особенности стационарного лечения. 

Результаты

Результаты. В 1 группе по сравнению со 2 группой значимо чаще регистрировали артериальную гипертензию (73,7% против 49%; p<0,05), у больных 1 группы был выше класс острой сердечной недостаточности по классификации Killip при поступлении (1,46±0,6 против 1,23±0,57; p<0,05). ИМпST у больных 1 группы на 12% чаще осложнялся развитием острой аневризмы левого желудочка (р<0,05). Длительность стационарного лечения пациентов 1 группы была больше (18±4,1 против 16±3,6 дней; p<0,05). 

Заключение

Заключение. Только 21% пациентов с СД, госпитализированных по поводу ИМпST, получали адекватное лечение ишемической болезни сердца, а четверть из этой группы не имела адекватной терапии СД. Пациенты с СД имели более высокую частоту госпитальных осложнений ИМпST и большую длительность стационарного лечения.

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The authors declare that there are no conflicts of interest present.