EUROMEDICA  Hanover 6-7  Juni 2008	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover Russian Academy of Natural Sciences, Moscow

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Urgency. Diabetes Milletus (DM) remains one of the urgent problems of medicine, for the last years it has become the significant one. WHO considers it to be a non-infectious epidemy of the 20^th century. Diabetes mellitus of type 2 is known to occur in 90-92% of cases.

In such patients a painless form of myocardial infarction (MI) prevailed resulted from presence of autonomous diabetic neuropathy, as well as transmural or macrofoccal myocardium affection.

Objectives. To study the extent of stenoses due to atherosclerotic process.

Materials and methods. 784 clinical case-histories of patients, which died from MI in 2007 and 2008 years were analyzed.

Results and discussion. Over the last 2 years in Almaty muncicipal clinical hospital 784 patients died from MI, in 153 patients DM was observed that accounted for 19.5%, besides all of them had DM of type 2, in 22 subjects the disease was detected for the 1^st time (14,1%). 124 (81%)- females aged from 49 to 92, average age 63,0 + 1,32 years prevailed. Lethal outcome occurred at different terms, frequently from 2 to 5 days -71%.

Primary MI (61%) prevailed, recurrent one was observed in 39% of patients. Among complications cardiogenic shock (92%) and edema of lungs (78%) were reported more frequently.

Arrhythmia of the heart was in 63% of patients, transmural MI occurred in 83% of cases. Mostly MI was located on anterior lateral walls, septum and apex (87%).

On autopsy in all died patients the spread of myocardium necrosis accounted from 40% to 90%, besides 90% of myocardium damage was noted in circularatory MI and at the age of 84-92 years. Heart mass was from 400 to 700 gr., at the average 524 + 1,05 gr. A wall of the left ventricle was hypertrophied, its sickness ranged from 1,5cm to 2,3cm at the average 1,7+ 0,67 cm. The degree of right and left arteries stenoses was different.

631 patients died from MI and disorders of carbohydrate metabolism were not detected. Significant differences on clinical, instrumental (ECG) parameters (MI spread, localization, complications) and autopsy data (spread of myocardium necrosis focus, stenoses of right and left coronary arteries, heart mass, thickness of left ventricle wall) were not marked at analysis of clinical case- histories of the died patients.

Conclusions:

1. Miocardial infarction was observed in patients with DM in 19,5% of cases.
2. Diabetes was firstly diagnosed in 14,1% of cases.
3. Transmural MI was registered in 83% of patients.
4. Stenoses of the left coronary artery prevailed over the right one.
5. Significant differences during MI in patients with DM and in patients without disorders of carbohydrate metabolism were not revealed.