Cardiovascular events and their outcome in diabetes and in people with prediabetes in the Coronary Unit of a Secondary General Hospital
Stergiani Petaloti, Zoe Roupab and Maria Noula
Background: The epidemic proportions that obesity, Diabetes Mellitus, as well as the progressive increase in the average life expectancy and consequently demographic aging are the main factors in the increase in the prevalence of Cardiovascular Diseases. Special reference is made to patients with prediabetes which usually works subclinical without obvious clinical symptoms.
Purpose-Methodology-Materials: This is a retrospective study of patients who were admitted with cardiovascular events to the Coronary Unit of a Secondary General Hospital in Greece over a period of three months. A convenience sample of 178 patients (mean age: 67, 7), who were admitted to the Coronary Unit participated in the study. The criteria for the diagnosis of cardiovascular events were based on the guidelines of the European Society of Cardiology.
Results: The findings are mostly in line with the literature, according to which the cardiovascular events in diabetics, as well as in people with Prediabetes, as the reason for admission of these people to the Coronary Unit, was Acute Myocardial Infarction in men at a rate of 19.5%, Acute Coronary Syndrome in 15.4% and Atrial Fibrillation in 13.8%, while in women the percentage of Acute Myocardial Infarction was 12.7%, of Acute Coronary Syndrome 10.9%, in contrast to Atrial Fibrillation it touched 23.8% and of Acute Pulmonary Oedema 20.0%. In relation to age, the highest percentage of Acute Myocardial Infarction was in the grouped age of 50-59 years, of Acute Coronary Syndrome at the age of 60-69 years, while of Atrial Fibrillation at the age of 70-79 years and at the same age the highest percentage of Acute Pulmonary Oedema. Regarding the outcome in days of hospitalization, the largest percentage of patients, similar in both sexes, was hospitalized for two days in the Coronary Unit with the largest percentage being transferred to the Cardiology Clinic for the continuation of the treatment process and a large percentage, which touched the 41.8% in total in both sexes, was transferred to an interventional center for further treatment. Death as an outcome was more common in women than in men.
Conclusions: People with Diabetes Mellitus have a three to five times greater risk of developing Coronary Heart Disease, even when other risk factors have been treated. It turns out that in addition to the well-known correlation between Diabetes Mellitus and Coronary Artery Disease, prediabetes, which acts subclinically, it is positively correlated with the occurrence of Coronary Artery Disease in patients who are hospitalized in a Coronary Unit. The productive age (50-59 years) is the age group with the highest percentage of Acute Myocardial Infarction, while the elderly (70-79 years) for Atrial Fibrillation. About half of the patients with Acute Myocardial Infarction are further treated with either coronary artery bypass grafting or coronary artery bypass grafting, while the prognosis was worse in women than in men. Early detection of diabetic and pre- diabetic patients and their effective treatment by medical and nursing staff, adherence to monitoring protocols for diabetic patients, a holistic and interdisciplinary approach with the participation of other health professionals, dietitians, and nutritionists are deemed necessary. Education, reinforcement and empowerment for behavior modification, self-care enhancement, as well as strengthening the cooperation of cardiologists and diabetologists in order to reduce cardiovascular events and their complications in the population.
Stergiani Petaloti, Zoe Roupab, Maria Noula. Cardiovascular events and their outcome in diabetes and in people with prediabetes in the Coronary Unit of a Secondary General Hospital. Int J Adv Res Nurs 2022;5(2):171-180. DOI: 10.33545/nursing.2022.v5.i2.C.283