Document Detail

The effect of diabetes on heart rate and other determinants of myocardial oxygen demand in acute coronary syndromes.
MedLine Citation:
PMID:  15317609     Owner:  NLM     Status:  MEDLINE    
AIMS: To compare major determinants of myocardial oxygen demand (heart rate, blood pressure and rate pressure product) in patients with and without diabetes admitted with acute coronary syndromes. METHODS: A cross-sectional study of the relation between diabetes and haemodynamic indices of myocardial oxygen demand in 2542 patients with acute coronary syndromes, of whom 1041 (41.0%) had acute myocardial infarction and 1501 (59.0%) unstable angina. RESULTS: Of the 2542 patients, 701 (27.6%) had diabetes. Major haemodynamic determinants of myocardial oxygen demand were higher in patients with than without diabetes: heart rate 80.0 +/- 20.4 vs. 75.2 +/- 19.2 beats/minute (P < 0.0001); systolic blood pressure 147.3 +/- 30.3 vs. 143.2 +/- 28.5 mmHg (P = 0.002); rate-pressure product 11533 +/- 4198 vs. 10541 +/- 3689 beats/minute x mmHg (P < 0.0001). Multiple regression analysis confirmed diabetes as a significant determinant of presenting heart rate [multiplicative coefficient (MC) 1.05; 95% confidence interval (CI) 1.03-1.07; P < 0.0001], rate pressure product (MC 1.09; CI 1.05-1.12; P < 0.0001) and systolic blood pressure, which was estimated to be 3.9 mmHg higher than in patients without diabetes (P=0.003). These effects of diabetes were independent of a range of baseline variables including acute left ventricular failure and mode of presentation (unstable angina or myocardial infarction). CONCLUSIONS: In acute coronary syndromes, heart rate and other determinants of myocardial oxygen demand are higher in patients with than without diabetes, providing a potential contributory mechanism of exaggerated regional ischaemia in this high-risk group.
K Foo; N Sekhri; C Knight; A Deaner; J Cooper; K Ranjadayalan; A Suliman; A D Timmis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  21     ISSN:  0742-3071     ISO Abbreviation:  Diabet. Med.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-19     Completed Date:  2004-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1025-31     Citation Subset:  IM    
Department of Cardiology Newham HealthCare NHS Trust, London, UK.
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MeSH Terms
Acute Disease
Blood Pressure / physiology
Coronary Disease / complications,  metabolism*
Cross-Sectional Studies
Diabetes Mellitus / metabolism*
Heart Rate / physiology
Middle Aged
Myocardium / metabolism*
Oxygen / metabolism*
Sex Factors
Reg. No./Substance:

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