Endocrine Abstracts

Patients type 2 diabetes mellitus and MI need multimodality treatment including, besides of drug therapy, non-drug approaches. Repeated Treadmil exercise test is open second window of preconditioning. Ischemic preconditioning limits infarct size in the heart, increase level of physical activity.

Study aim: To study the effect of early started repeated Treadmil exercise tests in patients with type 2 diabetes mellitus and MI.

Design: Open, randomized study on 124 MI and type 2 diabetes mellitus patients, 52.3±3.6 years old. Patients were on 5–7 day of MI and received a basic cardiovascular and dietary therapy with ACEI, aspirin, β-blokers and statins and were randomized to two treatment groups (62 patients in each) at 1:1 ratio. Group 1(control (CG)) – received a standard drug and dietary therapy and standard physical rehabilitations; group 2 (training (TG)) – received a standard drug and dietary therapy and 10 repeated exercise tests twice a day. The follow-up period was 12 months.

Study results: Characteristics ST depression did not differ significantly in both groups at the beginning. However after 10 days in TG durations of the ST depression significantly changed. Times for onset of ischemic changes (228±94 vs 365±103 s, P=0.01) and appearance of angina (282±153 vs 428±177 s, P=0.04) were observed. In CG ST depression characteristics were not significantly changed (238±96 vs 265±99 s) and appearance of angina (276±148 vs 293±153 s) were observed.

Physical activity tolerance were increase significantly in TG (42%), and increase not significantly in CG (8%).

Patients in TG had significantly less duration hospitalizations 15.1±2.3 and 18.6±2.2 days in the comparison group.

Total of 48 hospitalizations occurred during the follow-up period, 15 in the TG and 33 in the CG. Training group patients had significantly less hospitalizations due to cardiovascular cause (7.5 vs 37%).

Conclusion: Repeated exercise tests in patients with type 2 diabetes mellitus and myocardial infarction can be started in their acute period. It decrease myocardial ischemia, decrease duration of hospitalizations and number of hospitalizations and cardiovascular events during 12 month after MI.