The aim of the study was to provide the data on the course of myocardial infarction (Ml) associated with diabetes mellitus (DM) in hospital. Material and methods. 102 patients with Ml were included in two cohorts, first with DM, second — without DM. Groups were compatible by gender, age and standard therapy. Results. Angiocoronarography data have revealed that patients of group 1 were characterized by multiple vessels lesion due to "rescue" angioplasty with stenting performed 5 times. Patients with DM demonstrated in-hospital higher rate of both acute (by Killip) and chronic (by NYHA) heart failure of advanced degrees as well as recurrent Ml, early postinfarction angina pectoris, heart rhythm disorders and hematomas due to injections. Conclusion. The previously mentioned results lead to higher mortality in this group. Significant elevation of CRP, interleukin-6 and epidermal growth factor levels proved more activated systemic inflammatory response in patients with Ml and DM playing key role in pathogenesis of complications of the disease.
Skorodumova Е.А., Kostenko V.A., Siverina A.V., Fedorov A.N. Clinical and immunological aspects of the course of myocardial infarction associated with diabetes mellitus during hospital treatment // Saratov Journal of Medical Scientific Research, Vol. 11, Issue 3, 2015, pp. 287-290

Objective: to identify the most prognostically significant scale risk assessment of patients with acute coronary syndrome without ST-segment elevation in combination with diabetes mellitus type 2, chronic renal failure, multifo-cal coronarocardiosclerosis, dyscirculatory encephalopathy. Material and methods. 260 patients with acute coronary syndrome without ST-segment elevation were divided into 4 groups according to the presence of severe concomitant diseases: patients with diabetes mellitus type 2 (71 people), chronic renal failure (49), multifocal lesions of the coronary arteries (76) and patients with dyscirculatory encephalopathy of grade 2-3, including ischemic stroke (64). All patients were stratified by major scales risk: TIMI, GRACE, PURSUIT. The development of negative coronary events was assessed in hospital and during the year after discharge. On the basis of the results, all scales were studied using the criterion of Mann-Whitney and identified the most predictably significant groups of patients with specific comorbid conditions. Results. It is revealed that the significance of the scales TIMI and GRACE in the study of distant forecast (up to 6 months) is the most reliable with acute coronary syndrome without ST-segment elevation in combination with diabetes mellitus type 2. For the patients with combination with chronic renal insufficiency the best prognostic significance was obtained by the GRACE scale in the study of hospital risk and forecast up to 6 months. TIMI and GRACE scales in the study of hospital risk and forecast up to 6 months had the greatest prognostic significance for the patients with acute coronary syndrome without ST-segment elevation on the background of multifocal lesions of the coronary arteries. For the patients with dyscirculatory encephalopathy of the 2nd and 3rd grades, the greatest prognostic significance was obtained by stratification of risk on PURSUIT and GRACE scales in the study of hospital risk and forecast up to 6 months. Conclusion. The results demonstrate the necessity of a differentiated approach to the risk stratification of patients with acute coronary syndrome without ST-segment elevation depending on the grade of a severe comorbid disease.
Dorokhova O.V., Firsakova V.Yu., Andreev D.A., Maslennikova O.M. The study of the prognostic value scales of assessing the risk of adverse coronary events in patients with acute coronary syndrome without ST-segment elevation in combination with comorbid conditions // Saratov Journal of Medical Scientific Research, Vol. 10, Issue 4, 2014, pp. 809-814

Objective ― This study was conducted to determine whether HbA1c is a predictor of short term mortality and morbidity after coronary artery bypass graft operation. Methods ― The coronary artery bypass graft operation was performed on the patients between January 2009 and January 2013. Each patient's medical record was retrospectively reviewed. The patients who were included in the study were evaluated in groups of 60. One group was comprised of nondiabetic patients, whose HbA1c level is below 6% (the control group 0), the other included diabetic patients with the HbA1c level is between 6-6.9% (the group 1) and the last group, group 2, included those patients with HbA1c level is equal or greater than 7%. Pre, peri and post operation data was compared. The deaths that occured in the first 30 days were evaluated as mortality and complications as morbitity. Results ― While mortality was not observed in the control group, one incident was observed in group 1 and 5 in group 2, which corresponds to 1.7% and 8.3% respectively. The mortality ratio in the group with patients whose HbA1c was greater or equal to 7% found statistically significant compared to the control group (P=0.02). The following parameters were observed in group 2 and were found statistically significant: the need for dialisis (25%, P<0.01), atrial fibrillation (33%, P=0.01), revision due to bleeding (10%, P=0.18), cerebrovascular event (16,7%, P=0.01), duration of mechanic ventilation (19.5±21.6, P=0.06), duration of hospital stay (approximately 9.91±5.35 days, P=0.01), infection in scar (53%, P<0.01), mediastenit (11%, P=0.01) and urinary tract infection (10%, P=0.01) Conclusion ― We concluded that in those diabetic patients that elective coronart artery bypass graft is applied, highly reactive HbA1c levels (HbA1c ≥7), may indicate morbitity in the early stages of post operation.
Ümit Arslan, Mehmet Erdem Memetoğlu, Rasim Kutlu, Ozan Erbasan, Mehmet Tort, Eyüp Serhat Çalık, Ziya Yıldız, M. Ali Kaygın, Ozan Erdem, Ali İhsan Tekin Preoperative Hba1c level in prediction of short-term morbidity and mortality outcomes following coronary artery bypass grafting surgery // Russian Open Medical Journal, Vol. 4, Issue 2, 2015, pp. 0-0

The rate of diabetes as a cause of disease burden has increased over time. Psychological well being could be considered as an important factor in improving of chronic disease management and decrease of mortality and morbidity of disease. Despite, increasing of Diabetes and its burden in Iran, there is a few researches about psychological aspects of treatment. The aim of this study was identifying of psychological contributing factors in determination of psychological well being in Iranian diabetic patients. Methods – This cross-sectional study was done in 350 diabetic patients that hospitalized for diabetes or related problems. The questionnaire`s survey was assessed presence of depression and anxiety (Hospital Anxiety Depression Scale – HADS), family behaviors (Diabetes Specific Family Support – DSFS), quality of life (Iranian Diabetes QOL), self care (Diabetes Self-Care Activities Questionnaire) and mental health (General Health Questionnaire -GHQ). For analysis of data, we used Descriptive statistics, correlation and Two-way Analysis of Variance (ANOVA). P-value less 0.05 was considered to be significant. Results – About 2/3 of participants had depression and anxiety. Anxiety, depression and non supportive behaviors had negative correlation with well being, quality of life and self care. Increasing of anxiety and depression was decreased the well being about 50% and 65%, respectively. Being single would be decrease the mental well being about 2.5 times. Conclusion – The results of recent study support the recommendation to assess psychological well-being in patients with diabetes as one part of diabetes management.
Behshid Garrusi, Mohammad Reza Baneshi, Samaneh Moradi Psychosocial contributing factors that affect mental well being in diabetic patients // Russian Open Medical Journal, Vol. 2, Issue 1, 2013, pp. 106-0

The aim of the study was to investigate the clinical status of patients with atrial fibrillation (AF) and diabetes mellitus (DM) type 2 and to identify differences in the treatment of AF, conducted in the cardiology departments of multidisci-plinary teaching hospitals of the Saratov city. Materials and methods. A comparative retrospective analysis of 1041 pharmacoepidemiological solid history of patients with AF who were hospitalized in emergency, and in the planning department of cardiology of 2 multidisciplinary teaching hospitals of the Saratov city consecutively in a calendar year on the AF, recorded on an electrocardiogram. Results. Among all patients with AF, patients with DM accounted for 20.2%. Among them were women, they were younger, they developed fibrillation at a younger age, they differed more severe structural heart disease, among which was significantly greater with myocardial infarction, nearly all had symptoms of heart failure. Patients with DM performed less frequently cardioversion, and to monitor heart rate often preferred a combination of beta-blockers and digoxin. 100% of patients with DM had a higher risk of thromboembolic complications (91.9% without diabetes) in both groups, oral anticoagulants (OAC) prescribed often enough. Conclusion. DM was diagnosed in every fifth patient with AF, especially among women and patients with persistent AF and is associated with the presence of more severe organic heart disease compared with patients without DM. All patients on the background DM was a high risk of thromboembolic complications, i.e. OAC must be assigned in 100% of cases, but in the surveyed hospitals OAC were appointed only in 23% of cases.
Graifer l.V., Reshetko O.V., Furman N.V., Dolotovskaya P.V. Features of pharmacotherapy and clinical course of atrial fibrillation in patients with type 2 diabetes in real clinical practice. Saratov Journal of Medical Scientific // Saratov Journal of Medical Scientific Research, Vol. 10, Issue 1, 2014, pp. 178-185