PREVALENCE OF ACUTE NSTEMI IN DIABETIC PATIENTS AT REHMAN MEDICAL INSTITUTE PESHAWAR, PAKISTAN

Abstract

Diabetes mellitus (DM) is a significant risk factor for cardiovascular diseases, including acute myocardial infarction (AMI). Non-ST-elevation myocardial infarction (NSTEMI) poses diagnostic challenges due to its atypical presentation, particularly in diabetic patients. This study aims to investigate the prevalence of acute NSTEMI among diabetic patients at Rehman Medical Institute (RMI) in Peshawar, Pakistan. A retrospective analysis was conducted on medical records of diabetic patients admitted to RMI between January 1, 2023 to December 31, 2023. Patients diagnosed with NSTEMI were identified based on clinical criteria, electrocardiogram findings, and cardiac enzyme levels. Data on demographics, comorbidities, risk factors, and clinical outcomes were collected and analyzed. Among the diabetic patients, 105 (27.3%) did not have hypertension, whereas 280 (72.7%) had hypertension, with an odds ratio of 2.45 (95% CI: 1.61 - 3.73) for hypertension leading to NSTEMI. Smoking was present in 140 (36.4%) patients, showing an odds ratio of 1.92 (95% CI: 1.22 - 3.01) for smoking and NSTEMI. Additionally, 150 (39.0%) patients had a family history of heart disease, with an odds ratio of 1.78 (95% CI: 1.09 - 2.91) for family history and NSTEMI. The prevalence of NSTEMI increased with age: 33.3% in <40 years, 55.6% in 40 - 59 years, 83.7% in 60 - 79 years, and 69.2% in patients aged 80 or above. BMI showed a positive correlation with NSTEMI, with 40.3% of obese patients, 36.4% of overweight patients, and 20.8% of normal BMI patients experiencing NSTEMI. This study highlights the significant impact of hypertension, smoking, family history of heart disease, and advancing age on the prevalence of acute NSTEMI among diabetic patients. Strategies focusing on managing these risk factors are crucial in reducing the burden of NSTEMI in this high-risk population