Comparison of outcomes of diabetic and nondiabetic patients undergoing primary angioplasty for acute myocardial infarction

Harjai, Kishore J.; Stone, Gregg W.; Boura, Judy; Mattos, Luiz Alberto; Chandra, Harish; Cox, David A.; Grines, Lorelei; O’Neill, William W.; Grines, Cindy L.

doi:10.1016/s0002-9149(03)00145-0

Cited by 77 publications

(57 citation statements)

References 16 publications

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“…IDDM group had a 1.58 times higher risk (adjusted HR) for mortality during the five-year follow-up compared with patients without DM. The effect of DM on adverse outcomes in patients with STEMI treated pPCI has been shown in previous studies [5,6]. Antoniucci et al showed that there is a difference in mortality between diabetics and non-diabetics with the highest mortality rate in the group with IDDM [7].…”

Section: Medical Youthmentioning

confidence: 83%

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Long-term mortality after primary PCI for STEMI in patients with insulin-dependent diabetes mellitus

Zlatanović¹,

Zaharijev²,

Stanković³

2015

Med podmladak

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SažetakUvod: Primarna PCI (pPCI) je zlatni standard u lečenju bolesnika sa akutnim infarktom miokarda (AIM) sa ST elevacijom (STEMI).Cilj: Cilj ove studije je da ispita uticaj dijabetičnog statusa na prijemu na petogodišnje preživljavanje kod pacijenata sa STEMI lečenih pPCI.Materijal i metode: Konsekutivni podaci za 2087 pacijenata primljenih u periodu od 1. januara 2009. do 31. decembra 2010. godine sa dijagnozom akutnog STEMI su prikupljeni iz elektronske baze podataka sale za kateterizaciju klinike za kardiologiju KCS. Pacijenti su podeljeni u 3 grupe: bez diabetes mellitusa (DM), bolesnici sa DM koji nisu na insulinskoj terapiji -NIDDM (non-insulin dependent diabetes mellitus), bolesnici sa DM koji su na insulinskoj terapiji -IDDM (insulin dependent diabetes mellitus).Rezultat: 1664 (79,7%) nije imalo DM, 98 (4,7%) je imalo IDDM, a 325 (15,6%) je imalo NIDDM. Postojala je statistički značajna razlika u stopi mortaliteta između tri grupe nakon 30 dana, godinu dana i 5 godina od intervencije, a najviša stopa je zabeležna kod IDDM bolesnika, zatim u grupi NIDDM i najniža kod bolesnika bez DM (15,3% vs 8,3% vs 5,9%, p < 0,001 nakon 30 dana; 21,4% vs 15,4% vs 10,9%, p < 0,001 nakon godinu dana; 32,7% vs 24,3% vs 18,0% p < 0,001 nakon 5 godina). Takođe, postojala je visoko statistički značajna razlika u stopi petogodišnjeg mortaliteta između pacijenata sa i bez DM (26,2% vs 17,6%, p < 0,001). IDDM je bio nezavisan prediktor petogodišnjeg mortaliteta (HR=1,58, 95% CI 1,07-2,32, p = 0,02), dok NIDDM nije dostigao statističku značajnost (HR = 1,24, 95% CI 0,95-1,63, p = 0,12).Zaključak: Kod bolesnika sa DM postoji povišen rizik od smrtnosti u kratkoročnom i dugoročnom praćenju nakon pPCI. Insulin-zavisan diabetes je nezavisan prediktor višeg petogodišnjeg mortliteta. Ključne reči: DM, IDDM, NIDDM, STEMI, pPCI AbstractIntroduction: Primary PCI (pPCI) is the gold standard in the treatment of patients with acute myocardial infarction (AMI) with ST elevation (STEMI).Aim: The purpose of this study is to evaluate the influence of diabetic status upon arrival at five year survival in patients with STEMI that were treated with pPCI.Material and methods: Consecutive data for 2087 patients admitted in the period from 1 st of January 2009. to 31 st of December 2010. with diagnosis of acute STEMI were collected from catheterisation laboratory cardiology clinic CCS electronic database. Patients were divided into 3 groups: those without diabetes mellitus (DM), IDDM (insulin dependent diabetes mellitus), NIDDM (non-insulin dependent diabetes mellitus).Results: 1664 patients (79.7%) did not have DM, 98 (4.7%) had IDDM and 325 (15.6%) had NIDDM. There was a statistically significant difference in mortality rate among three groups after 30 days, one year and five years after intervention, and the highest rates were recorded at the IDDM patients, then at the NIDDM and the lowest in patients without DM (15.3% vs 8.3% vs 5.9 %, p < 0.001 after 30 days; 21.4% vs 15.4% vs 10.9%, p < 0.001 after one year and 32.7% vs 24.3% vs 18%, p < 0.00...

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Section: Medical Youthmentioning

confidence: 83%

“…Original articles pPCI [5,6]. After performing the stratification of patients with DM in those with IDDM and NIDDM, IDDM was shown to be an independent predictor of mortality after five-year follow-up, when compared with NIDDM.…”

Section: Medical Youthmentioning

confidence: 99%

Long-term mortality after primary PCI for STEMI in patients with insulin-dependent diabetes mellitus

Zlatanović¹,

Zaharijev²,

Stanković³

2015

Med podmladak

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“…27 The increasing number of reports suggests that the prognosis of diabetic patients with myocardial infarction can be improved to the level observed in nondiabetic populations. According to the German registry, in-hospital mortality in diabetic patients with acute myocardial infarction was 29% in 1999.…”

Section: Resultsmentioning

confidence: 99%

Does Reperfusion in the Treatment of Acute Myocardial Infarction Improve the Prognosis of Acute Myocardial Infarction in Diabetic Patients?

Janion¹,

Polewczyk

Gąsior

et al. 2009

Clinical Cardiology

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Background: Diabetic patients have a 6-fold increased mortality in acute coronary syndromes. Hypothesis: Different therapeutic strategies in diabetics with acute coronary syndromes have an impact on in-hospital and long-term prognosis. Methods: A total of 889 consecutive patients with ST-segment elevation myocardial infarction were included and followed-up for at least 6 months. The study population consisted of 168 (18.9%) diabetic patients and 721 nondiabetics. Results: Invasive therapy and fibrinolysis were less frequently used in diabetic patients (38.7% versus 50.2%; p = 0.0071 and 8.3% versus 15%; p = 0.024, respectively). In-hospital mortality in diabetic individuals was almost twice as high as in nondiabetic subjects (20.2% versus 11.1%; p<0.0014). In-hospital mortality was slightly higher in diabetic patients undergoing primary percutaneous transluminal coronary angioplasty (PTCA; 8.3% versus 4.8%; p = 0.35), but lower in those treated with fibrinolysis (7.7% versus 16%; p = 0.7) compared with the rest of the patients. At 6-mo follow-up mortality was significantly higher in diabetic subjects as compared with nondiabetic subjects (28.0% versus 15.1%; p<0.0001). The highest number of deaths was found in individuals receiving conservative treatment with diabetic subjects significantly outnumbering nondiabetic individuals (40.1% versus 27.9%; p = 0.028 at 6 mo). Both in-hospital and 6-mo mortality were similar in diabetics and nondiabetics receiving reperfusion therapy (7.1% versus 8.2%; p<0.68 and 9.3% versus 15.3%; p<0.098, respectively). Conclusion: Reperfusion therapy, both fibrinolysis and the invasive approach, reduced in-hospital mortality from that observed in nondiabetic individuals.

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“…Так, при СД чаще отмечаются повторные инфаркты миокарда, выше постинфарктная смертность, больше зона инфаркта, а после инфаркта чаще отмечается развитие ХСН [17]. В связи с этим до начала исследования предполагалось, что НУО, ско-рее всего, будут отрицательно влиять на состояние кол-латерального кровотока.…”

Section: Discussionunclassified

Carbohydrate metabolism disorders and coronary collateral circulation in patients with chronic coronary artery disease

Старостин¹,

Talitskiy²,

Булкина³

et al. 2015

Diabetes mellitus

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Comparison of outcomes of diabetic and nondiabetic patients undergoing primary angioplasty for acute myocardial infarction

Cited by 77 publications

References 16 publications

Long-term mortality after primary PCI for STEMI in patients with insulin-dependent diabetes mellitus

Long-term mortality after primary PCI for STEMI in patients with insulin-dependent diabetes mellitus

Does Reperfusion in the Treatment of Acute Myocardial Infarction Improve the Prognosis of Acute Myocardial Infarction in Diabetic Patients?

Carbohydrate metabolism disorders and coronary collateral circulation in patients with chronic coronary artery disease

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