Myocardial Infarction Mortality
1.0 Introduction
In the UK, about 838,000 men and 394,000 women have had a myocardial infarction (MI) at some point in their lives, (NICE clinical guideline 48, 2007). The latest statistics from the British Heart Foundation state that approximately 227,000 people suffer from an acute MI (heart attack) each year (British Heart Foundation Statistics Website).
To put this figure in to perspective this equates to one person every 2 minutes. Mortality is at approximately 30% which is 68,100 deaths in the UK per year. The National Service Framework (NSF) for Coronary Heart disease (CHD) is a 10-year programme published by the Department of Health in 2000 and has set key standards for the prevention and treatment of CHD.
Access to the right treatment for those who suffer from an AMI, is essential to reduce morbidity and mortality and improve clinical outcomes.
People with diabetes mellitus constitute a group of patients who have a higher risk of having an MI and also a poorer prognosis post infarction. The higher death and complication rates appear to be multifactorial but a significant finding in the Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) Trial showed to reduce one year mortality by 30% (Malberg et al., 1995). It’s recommended
1.1 Primary Objective
To determine the relationship between HbA1c and prognosis of patients in East Lancashire having a myocardial infarction.
1.2 Secondary Objectives
To assess the prognosis of patients below the glucose cut off threshold for DIGAMI treatment and whether or not this borderline category falls in to the highest risk group in terms of mortality and morbidity.
To determine if there is both a clinical and analytical case to use fluoride oxalate tubes for plasma glucose and HbA1c collection and analysis in East Lancashire.
To ascertain the effect of a