Badly controlled hyperglycaemia provokes arrhythmia and may increase cardiovascular risk in diabetic patients
Ivan Smirnov, Irina Ilchenko & Larysa Zhuravlyova
Cardiovascular risk (CR) in patients with diabetes mellitus (DM) is high. Arrhythmias (Ar) could increase CR as well. We aimed to define is there any association between hyperglycemia and incidence of Ar. We studied 137 (75 F/62 M) type 2 diabetic patients with coronary artery disease (CAD). The age was 54.0±5.5 years (M±S.D). The CAD and DM duration <10 years was in 64 (47%) and in 47 (34%), 15 years and above in 21 (15%) and in 34 (25%) respectively. Seventy-seven patients (Group 1) had got A1c>10%. Sixty controls with A1c<7% were enrolled in the Group 2. Groups were matched for gender, age and CAD duration. No significant differences in either serum total cholesterol, triglycerides, HDL-C, or the history of myocardial infarction between groups were found. Groups differed in serum potassium level (3.98±0.19 vs 4.04±0.16; P<0.05). In 29 (38%) patients from Group 1 and in 13 (22%) patients from Group 2 Ar were sustained and clinically seen (P<0.05), in 71 (92%) patients from Group 1 and in 47 (78%) from Group 2 (P<0.05) Ar were sporadic and found after 24-h ECG monitoring. There were episodes of atrial fibrillation in 57 vs 32 (P<0.02), atrial extrasystolia single in 64 vs 45 (NS) and group in 58 vs 34 (P<0.05), ventricular extrasystolia single in 61 vs 38 (P<0.05) and group in 51 vs 29 (P<0.05), atrial in 48 vs 22 (P<0.01) and ventricular tachyarrhythmia in 29 vs 13 (P<0.05), early ventricular extrasystolia in 27 vs 13 (NS) and early atrial extrasystolia in 36 vs 17 (P<0.05) patients of Group 1 and Group 2 respectively. We concluded the glycaemic control is associated with Ar incidence, and this could contribute to the higher CR in DM.