STUDY OF CLINICAL PROFILE OF MYOCARDIAL INFARCTION IN TYPE-2 DIABETES MELLITUS PATIENTS WITH GENDER DIFFERENCE

BACKGROUND: Atherosclerotic heart disease in diabetes appears earlier in life, affects women almost as often as men and is more fatal. Commonly women are considered at lower risk of Coronary Artery Disease [CAD] morbidity and mortality than men, but it is now widely believed that diabetes erases this female advantage and increases the risk of CAD to a greater extent than in males. This study was done to show clinical profile, ECG and enzyme changes of male and female diabetic patients with myocardial infarction and to note the gender impact on outcome of myocardial infarction during hospital stay. METHODOLOGY: 50 male and 50 female diabetes mellitus patients who sustained myocardial infarction were studied with reference to the gender differences in their presentation, clinical parameters, in hospital complications and prognosis. RESULTS: The mean age of females was 59.8 +/- 11yrs and males 56.5 +/- 10yrs with history of hypertension in 46% females and 38% males. Obesity was seen in 20% of females vs. 14% males and dyslipidemia in 74% vs. 50%. HbA1c>8 was present in 98% females vs. 60% males. Clinical signs like hypotension raised JVP, pulmonary edema and post MI complications were noted more in females. STEMI occurred in 80% of females and 86% of males. The overall mortality was 20% in females and 6% in males was statistically significant. CONCLUSIONS: Female diabetic patients presenting with myocardial infarction were older than their male counterparts with history of hypertension being more common in them. More number of female patients had dyslipidemia, higher HbA1c and obesity than males. Non-chest pain symptoms were more common in female diabetics and fatigue was observed more in them. Clinical signs on presentation were worse for females and post MI complications and the in-hospital mortality was higher in female patients than males.