INFLUENCE OF TYPE 2 DIABETES MELLITUS ON THE KILLIP CLASS IN ACUTE MYOCARDIAL INFARCTION PATIENTS VISITING HAYATABAD MEDICAL COMPLEX, PESHAWAR, KHYBER PAKHTUNKHWA

Abstract

Introduction: Diabetes mellitus (DM) is well known risk factor for myocardial infarction. Some studies report that DM also affects the Killip class of heart failure in post-Acute Myocardial Infarction (AMI) patients. This study was carried out to evaluate the influence of concomitant DM and AMI on Killip class of heart failure.

Materials & Methods: This was a case-control study in which data were collected from 196 patients, who presented with AMI to Department of Cardiology in Hayatabad Medical Complex (HMC) between September and December, 2015. Cases were those who had type 2 Diabetes Mellitus (T2DM) along with AMI, while controls were those AMI patients who were not having T2DM. Within each group, subgroups were made on the basis of Killip Classification. Assessment was done by expert cardiologists. Non-probability convenience sampling technique was used. Data were collected on Performa comprising of demographic data, clinical assessment and Killip scale assessment. Data were analyzed by SPSS version 16.

Results: A total of 196 subjects from both sexes who presented with first AMI were included in the study. Mean age was 59±7.58 years. Out of 196 subjects who had AMI, 17.86% were type 2 diabetics and 82.14% were non-diabetics (p<0.001). There was no significant difference in terms of gender (p=0.79), age (p=0.72), weight (p=0.53), height (p=1.00), body mass index (p=0.33), heart rate (p=0.85), systolic blood pressure (p=0.80) and diastolic blood pressure (p=0.83) between diabetics and non-diabetics. In AMI patients without diabetes mellitus (control group), 57.1% patients did not develop heart failure, 13.7% patients were in Killip Class II, 19.9% were in Killip Class III, and 9.3% were in Killip class IV. In contrast, , 57.1 % AMI patients with diabetes mellitus didn’t develop heart failure (OR = 1.00, 95% CI: 0.48 to 2.09, p=1.00), 22.9% patients were in Killip Class II (OR=1.67, 95% CI: 0.65 to 4.29, p=0.28), 11.4% were in Killip Class III (OR=0.57, 95% CI: 0.18 to 1.81, p=0.34), and 8.5% were in Killip Class IV (OR=0.92, 95% CI:

0.24 to 3.48 , p=0.92). There was insignificant difference between two groups (p>0.05).

Conclusion: Though Type 2 Diabetes Mellitus is one of the major risk factor for Acute Myocardial Infarction, however, concomitant Diabetes Mellitus and Acute Myocardial Infarction do not influence the Killip class outcome (heart failure).