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50% heart attack patients in north India suffer from pre-diabetes: Study

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NEW DELHI: Nearly one out of every two patients rushed to a hospital with a full-blown heart attack caused by blockage of an artery — referred to as ST-Elevation Myocardial Infarction (STEMI) in clinical terms — suffer from undiagnosed diabetes or pre-diabetes, according to a study published in the Global Heart Journal.

The finding is based on the screening results of 3,523 patients from North India who were treated at two leading hospitals in Delhi — G B Pant Hospital and Janakpuri Super Specialty Hospital — between January 2019 and February 2020 for STEMI.

Only 855 (24%) of them were known as diabetic. However, tests conducted to check blood sugar levels at the time of hospitalisation revealed that 41% of others were either pre-diabetic (28%) or diabetic (13%), but they did not know about it.

Diabetes is a known risk factor for cardiovascular diseases. The principal investigator and author of the study, Dr Mohit Gupta, told TOI that timely detection and management of diabetes may have reduced the risk of heart attack (STEMI) in many of these patients. “Everyone, aged 18 years and above, should get themself tested for diabetes periodically. This will help them ward off serious complications such as a heart attack in future,” he said. Diabetes, he added, not only increases the risk of a heart attack but also worsens the outcome as well.

In the study, the G B Pant Hospital doctor said, it was found that patients with pre-diabetes (49%), newly-detected diabetes (53%), and established diabetes (48%) experienced higher rates of left ventricular dysfunction after the heart attack as compared to the non-diabetics (42%).

The left ventricle is the main chamber of the heart. It is responsible for pumping oxygen-rich blood into the aorta (the largest artery in the body). Left ventricular dysfunction is characterised by its stiffening, which can lead to the weakening of the heart and subsequent heart failure.

Even among the established diabetes cases, disease management wasn’t proper. Many of the patients had uncontrolled blood sugar levels, resulting in poorer outcomes. In-hospital mortality was higher among the pre-diabetics and diabetics (newly diagnosed and established cases) than non-diabetics.

Overall, the authors concluded that these data highlight gaps in dysglycemia (raised blood sugar levels ) surveillance and management among high-risk patients in north India.

“These missed opportunities are especially problematic in low and middle-income countries (LMICs), where limited access to timely percutaneous coronary intervention and secondary prevention medical therapy may contribute to additional death and disability,” they added. The International Diabetes Federation has estimated that over 40 million people in India have unrecognised diabetes.

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