Diabetes and myocardial infarction

Myocardial infarction (MI) is a common cause of mortality in people with diabetes. The case fatality from MI is high and may be reduced by thrombolysis and treatment with aspirin, beta-blockers and angiotensin-converting enzyme inhibitors. Poor metabolic control is common among diabetic patients with MI, but the importance of controlling blood glucose during and following an MI is debatable. Treatment with statins reduces cardiovascular end-points in diabetic patients with previous MI (secondary prevention). Large studies in diabetic patients without existing heart disease have shown statistically insignificant reductions in heart disease and MI with improved glycaemic control of the diabetes (primary prevention). The treatment of hypertension in people with diabetes prevents cardiovascular end-points, and studies on whether the treatment of hyperlipidaemia reduces heart disease and MI are proceeding.