Objective: To assess the patients of microalbuminuria in acute myocardial infarction (AMI) with diabetic mellitus (DM), mainly mortality.
Methodology: This descriptive cross sectional study was conducted in the Department of Cardiology, Liquate University Hospital, Hyderabad, Pakistan and included 126 patients of AMI. The diagnosis of AMI was based on the presence of typical chest pain, which was associated with diaphoresis along with electrocardiographic findings and elevated Troponin I. The sample population was divided into two categories: Group A with microalbuminuria and Group B without it. Mechanical and other complications of AMI were assessed by echocardiography and serial electrocardiographic monitoring. Detailed history of patients regarding presence of risk factors was also noted. Outcome was noted according to the mortality ration in both groups. All clinical and laboratory data were collected during the first week of hospitalization.
Results: The mean age was 49.5±7.85 years (range 20-80). Male were in majority (59.3%). Systolic blood pressure was noted in the 131 patients with microalbuminuria with range of 127-135mmHg and in the 129 patients with normo albumanuria systolic blood pressure was found with range of 127-135mmHg. Diastolic blood pressure was found in the 76 patients with microalbuminuria with range of 75-81mmHg and in the 76 patients of normoalbumanuria with range of 74-78mmHg. On the 24 hours urine outcome, CK-MB was found as mean 222.5±158.8, while microalbuminuria was noted as mean of 65.66±60.19. Hypertension was seen in 41.26% and family history of cardiac disease was found in 33.33%. Dyslipidemia was found in 30.15% of the patients and elevated HbA1c was recorded in 27.77% cases. On the outcome, mortality was noted in 12.8% patients of microalbuminuria, which is greater than the patients of normoalbuminuria as 7.5% (P=0.02).
Conclusion: The mortality increased in the cases of AMI with microalbuminuria. Microalbuminuria can be used as a predictor for the early detection of cardiovascular changes along with the lipid profile markers in the general population to prevent the mortality and morbidity due to acute myocardial infarction.
Key words: Microalbuminurea, diabetic patients, acute MI
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