Cardiac arrhythmias in patients with acute myocardial ischemia, which developed on the background of comorbid hypertension and diabetes

Abstract

Acute coronary syndrome (ACS) is one of the leading causes of deaths in the world. The development of acute myocardial ischemia is accompanied by cardiac arrhythmias (CА), especially in conditions of comorbidity. In most patients (up to 80 %) MI develops on the background of arterial hypertension (AH), and in 50 % – diabetes mellitus (DM). The aim of the study – to compare current scientific data on arrhythmias in the acute period of myocardial infarction on the background of hypertension and diabetes and compare them with the data of own studies. Materials and Methods. Data from 2145 patients aged 29–89 years, mean age (65.10±0.37) years, men – 70.57 %, women – 29.43 % were selected for the study, who were divided into 4 groups: group 1 (n = 1061) – patients with MI and concomitant hypertension without diabetes (MI + hypertension without diabetes), group 2 (n = 400) included patients with MI and concomitant hypertension and diabetes (MI + hyperten-sion + diabetes), group 3 ( n = 355) – patients with MI with-out hypertension and diabetes, group 4 (n = 329) – patients with MI without concomitant pathology. With the help of the licensed program SPSS v.21 statistical processing of data en-tered in spreadsheets Excel – 2010. Results. In our study, significant СА in the acute period were manifested by supraventricular (9.8 %) and ventricular (18.7 %) extrasystoles, paroxysms of supraventricular (1.4 %) and ventricular (5 %) tachycardia, ventricular fibrillation (2.9 %), paroxysms of atrial fibrillation (9 %), and in 6.3 % of MI developed on the background of chronic atrial fibrillation. Violation of atrioventricular conduction degree I–III was recorded in 4.6–2.2 %, on the His bundle – in 7.2 % on the right leg, in 5 % – on the left leg. Most СА were observed in patients with MI and concomitant hypertension and diabetes. Ventricular arrhythmias were observed in patients with-out concomitant hypertension and diabetes. Chronic atrial fibrillation was prevalent in patients without concomitant diabetes. Conclusions. Comorbid pathology, in particular hypertension and diabetes, enhances the proarrhythmogenic potential of the myocardium in acute ischemia and worsens the early and long-term prognosis after MI, which requires optimization of management of such patients

Keywords

• myocardial infarction
• cardiac arrhythmia
• arterial hypertension
• diabetes mellitus