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The British Journal of Diabetes & Vascular Disease
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Review: The management of acute myocardial infarction in patients with diabetes mellitus

Ian L Williams

Department of Cardiology, Guy's, King's and St Thomas' School of Medicine, London, UK, ian.williams{at}kingsch.nhs.uk

Brian Noronha

Department of Cardiology, Guy's, King's and St Thomas' School of Medicine, London, UK

Azfar G Zaman

Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, UK

Diabetic subjects are more likely to experience a myocardial infarction and have worse outcomes compared to non-diabetic subjects. The underlying pathophysiology of the atherosclerotic process is not significantly different in diabetic subjects, but the prothrombotic and procoagulant state with which diabetes is associated is thought to contribute to the higher incidence of and worse prognosis after myocardial infarction. Difficulties of re-establishing vessel patency by thrombolytic or mechanical means contribute to the high morbidity and mortality. The diffuse nature of arterial disease with accompanying metabolic derangement contribute to impaired compensatory mechanisms, increased infarct size and a disproportionately more substantial impairment of left ventricular function. The newer adjuvant antithrombotic and anticoagulant agents have particular roles in management therefore and careful modulation of glucose metabolism in the acute and follow-up phase of an infarct may favourably influence outcome.

Key Words: diabetes mellitus • myocardial infarction • acute management.

The British Journal of Diabetes & Vascular Disease, Vol. 3, No. 5, 319-324 (2003)
DOI: 10.1177/14746514030030050201
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S. Sulfi and A. D Timmis
Review: Heart failure complicating acute myocardial infarction in patients with diabetes: pathophysiology and management strategies
The British Journal of Diabetes & Vascular Disease, September 1, 2006; 6(5): 191 - 196.
[Abstract] [PDF]