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Diabetes and Kidney Dysfunction Worsen Prognosis Post Heart Attack

by Simi Paknikar on  November 11, 2011 at 3:56 PM Health In Focus   - G J E 4
Kidney dysfunction and diabetes are known to affect the outcome of a patient following a heart attack. Deaths following a heart attack are higher in patients suffering from either of these conditions.
 Diabetes and Kidney Dysfunction Worsen Prognosis Post Heart Attack
Diabetes and Kidney Dysfunction Worsen Prognosis Post Heart Attack
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Kidney dysfunction causes a number of changes in the body that contribute to heart-related events.  These include anemia, increase in homocysteine levels, increase in oxidation of LDL, and decrease in nitric oxide production.  These could lead to thickening of the arteries and increase the chances of suffering from heart attack and other heart conditions.  Kidney failure could also contribute to the development of left ventricular hypertrophy (thickening of a lower heart chamber), resulting in increase in a number of cardiac deaths.

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Diabetes also increases the chances of heart disease through multiple mechanisms.  These include accumulation of oxygen-free radicals, damage to the inner lining of blood vessels, and abnormalities in clot formation and breakdown process.

Researchers in Korea studied the consequence of a combination of diabetes and kidney dysfunction in patients who had suffered a heart attack.  They studied the records of 9905 patients who suffered from a heart attack between November 2005 and August 2008.  The records were classified into 4 groups: 

·        Group I patients did not suffer from diabetes or kidney insufficiency

·        Group II patients suffered from diabetes but not kidney insufficiency

·        Group III patients suffered from kidney dysfunction but not diabetes

·        Group IV patients suffered from both -diabetes and kidney dysfunction

The researchers found that patients in Group IV, that is, suffering from diabetes as well as kidney insufficiency, had more number of major heart events including heart attacks, bypass surgeries as well as deaths after 1year of follow-up.

Patients with only diabetes also suffered from more major cardiac events than patients without diabetes (Group I patients) at the end of 1 year.  Similar observations were seen in patients with only kidney disease, that is, patients with only kidney disease had more number of adverse heart events at the end of 1 year compared to Group I patients.  Deaths at 1 year after a heart attack were also more common in patients with kidney disease.  In fact, patients with kidney disease were likely to suffer from adverse heart effects irrespective of whether they suffered from diabetes or not.

The study thus concluded that patients with kidney dysfunction as well as diabetes were more likely to suffer from heart-related adverse effects and death following a heart attack than someone with either one or neither of the above conditions. 

Reference:

1. Chang Seong Kim et al.  Concomitant renal insufficiency and diabetes mellitus as prognostic factors for acute myocardial infarction.  Cardiovascular Diabetology 2011, 10:95

Source: Medindia
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