BIOCHEMICAL MARKERS IN ACUTE MYOCARDIAL INFARCTION PATIENTS WITH AND WITHOUT DIABETES MELLITUS: A COMPARATIVE STUDY

Abstract

Introduction: Acute myocardial infarction (AMI) is a leading cause of death, and diabetes mellitus is one of its strongest risk factors. Aim: To compare biochemical markers, namely homocysteine, glycemic parameters, cardiac markers (troponin I, CK-MB, AST) and lipid profile, in AMI patients with and without diabetes mellitus. Methods: A total of 94 AMI patients were studied: 50 with diabetes and 44 without. Results: Mean age was similar in the two groups (53.2 ± 17.8 vs 54.6 ± 18.6 years), as was the sex distribution (66.0% vs 61.4% male). As expected, random blood sugar (237.6 ± 65.4 vs 111.2 ± 18.1 mg/dL) and HbA1c (9.8 ± 1.9 vs 5.2 ± 0.3%) were markedly higher in diabetic patients (both P < 0.001). Mean serum homocysteine was more than 80% higher in diabetic patients (25.3 ± 7.2 vs 13.8 ± 4.6 μmol/L, P < 0.001); hyperhomocysteinemia (≥15 μmol/L) was present in 84% of diabetic and 23% of non-diabetic patients, and severe hyperhomocysteinemia (≥30 μmol/L) in 36% and 5%, respectively (both P < 0.001). CK-MB (211.4 ± 141.8 vs 179.2 ± 108.6 U/L, P = 0.024) and AST (187.6 ± 109.8 vs 156.8 ± 101.4 U/L, P = 0.034) were higher in diabetic patients, whereas mean troponin I was 12.27 ± 16.68 ng/mL in diabetic and 14.15 ± 17.11 ng/mL in non-diabetic patients. Conclusion: These findings indicate that AMI patients with diabetes carry a heavier burden of hyperglycemia, hyperhomocysteinemia and enzymatic evidence of myocardial injury than those without diabetes. Homocysteine estimation alongside conventional cardiac markers may help refine risk assessment in diabetic AMI patients, although prospective studies are needed to establish its prognostic value.