Outpatient follow-up of patients with myocardial infarction and early carbohydrate metabolism disorders

Aim. To assess the quality of treatment of patients with myocardial infarction (MI) and early carbohydrate metabolism disorders as part of outpatient follow-up. Material and methods. The study was conducted within the outpatient registry of patients after myocardial infarction PROFILE-MI, which included all patients who visited a cardiologist at Moscow City Polyclinic № 9 after myocardial infarction from March 1, 2014 to June 30, 2015. A total of 160 people were included as follows: 106 (66,2%) men and 54 (33,8%) women; mean age, 70,4±10,8 (from 39 to 87) years. Visits were carried out every 2 months. Fasting plasma glucose levels were assessed. The follow-up lasted 1 year. Patients with carbohydrate metabolism disorders 68 (42,5%) were divided into 3 following groups: 1: patients with a history of type 2 diabetes (T2D) or diagnosed at the inpatient stage — 45 (28%); 2: patients with a history of impaired glucose tolerance (IGT) or diagnosed at the inpatient stage — 6 (4%); 3: patients without T2D or IGT (n=109), in whom impaired fasting glycemia was recorded for the first time at the outpatient stage — 17 (16%). The prescription rate of metformin was assessed in all groups. Results. There were 23 (14,4%) patients with early carbohydrate metabolism disorders included in the registry. In group 3, there were significantly more men than in groups 1 and 2 — 76,5 vs 42 and 33% (p<0,001), and the mean age of 59,8±11,9 years was lower — 64,04±11,4 and 72,5±6,8 years (p=0,033), respectively. In this group, there were no smoking patients (p=0,007), fewer obese patients (18 vs 44 and 33%), but more overweight individuals compared to group 1 (47 vs 40%). In addition, burdened heredity (47 vs 64 and 67%), hypertension (65 vs 84 and 100%) were less frequently registered, respectively. The proportion of patients with a history of coronary artery disease was lower in group 3 compared to group 1 and amounted to 29 vs 47% (p=0,012). During the follow-up period, the prevalence of blood glucose testing did not exceed 44%. Metformin was prescribed only to patients of group 1 upon discharge from the hospital — 3 (6,7%), while metformin therapy was not prescribed to patients of groups 2 and 3. Conclusion. According to the PROFILE-MI registry, the total prevalence of early carbohydrate metabolism disorders among patients with a history of MI was quite high and amounted to 14,4%. This category of patients had a less complicated cardiovascular history. In real-world practice, metformin was not prescribed to patients with early carbohydrate metabolism disorders.