Effects of prediabetes on long-term clinical outcomes of patients with acute myocardial infarction who underwent PCI using new-generation drug-eluting stents

Kim, Yong Hoon; Her, Ae Young; Cho, Jeong Gwan; Kim, Byeong Keuk; Hong, Sung Jin; Kim, Seunghwan; Ahn, Chul‐Min; Kim, Jung Sun; Ko, Young Guk; Choi, Donghoon; Hong, Myeong Ki; Jang, Yangsoo

doi:10.1016/j.diabres.2019.107994

Cited by 18 publications

(27 citation statements)

References 44 publications

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“…Recent reports [20,21] also showed that the patency of the IRA in patients with STEMI was related to procedural success and decreased enzymatic infarct size, fatal arrhythmic events, and in-hospital mortality. Because recent studies [5][6][7] did not use TIMI ow grade as a variable in estimating the clinical outcomes between these two groups, we considered that the TIMI ow grade can be used as a meaningful variable for the comparison of major clinical outcomes between prediabetes and T2DM.…”

Section: Discussionmentioning

confidence: 99%

“…First, although KAMIR is prospective registry, 8 this is a retrospective study. Therefore, some data might have usual limitations and biases inherent to retrospective study designs [7,28]. Especially, because patients of this study were enrolled over a wide range of time (from November 2005 to June 2015), the various treatment options, the different guidelines suggestions, and treatment goals for patients with T2DM that have risen during this period were able to have a great impact on this study and our results may differ over time.…”

Section: Limitationsmentioning

confidence: 98%

“…The degree of coronary ow before PCI was classi ed according to TIMI ow grade as assessed by the investigators [13]. Glycemic categories were determined according to medical history and HbA1c and fasting plasma glucose (FPG) or random plasma glucose (RPG) levels at the index hospitalization [7]. We classi ed glycemic categories according to the American Diabetes Association guidelines [14].…”

Section: Study De Nitions and Clinical Outcomesmentioning

confidence: 99%

“…We classi ed glycemic categories according to the American Diabetes Association guidelines [14]. Normoglycemia was de ned as HbA1c < 5.7% and FPG < 100 mg/dL (5.6 mmol/L), prediabetes as HbA1c 5.7-6.4% and FPG 100-125 mg/dL (5.6-6.9 mmol/L), and T2DM as known T2DM for which patients receive medical treatment (insulin or antidiabetics) or as newly diagnosed T2DM de ned as HbA1c ≥ 6.5%, FPG ≥ 126 mg/dL (7.0 mmol/L), or RPG ≥ 200 mg/dL (11.1 mmol/L) [7]. If there were some discrepancy between the level of HbA1c and those FPG or RPG, we made the level of HbA1c a priority [15].…”

Section: Study De Nitions and Clinical Outcomesmentioning

confidence: 99%

“…This potential stress-induced hyperglycemia may have served as an important bias in this study. Fourth, compared with an oral glucose test, measurement of HbA1c may not be ideal [7]. Moreover, it has been proposed that impaired glucose tolerance (IGT) prediabetes may be associated with a higher cardiovascular risk compared to the impaired fasting glucose (IFG) subtype [32].…”

Section: Limitationsmentioning

confidence: 99%

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Impact of Pre-percutaneous Coronary Intervention Thrombolysis in Myocardial Infarction Flow Grade in Patients With ST-segment Elevation Myocardial Infarction and Prediabetes or Diabetes After Successful Newer-generation Drug-eluting Stent Implantation

Kim

Her

Jeong

et al. 2020

Preprint

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Background: Studies comparing long-term clinical outcomes between prediabetes and diabetes based on pre-percutaneous coronary intervention (PCI) Thrombolysis in Myocardial Infarction (TIMI) flow grade in patients with ST-segment elevation myocardial infarction (STEMI) after successful PCI with newer-generation drug-eluting stents are limited. We compared 2-year clinical outcomes of these two groups. Methods: Overall, 6448 STEMI patients were divided into two groups: pre-PCI TIMI 0/1 group (n = 4854) and pre-PCI TIMI 2/3 group (n = 1594). Subsequently, these two groups were further divided into patients with normoglycemia, prediabetes, and type 2 diabetes mellitus (T2DM). The major endpoint was the occurrence of major adverse cardiac events (MACEs), defined as all-cause death, recurrent myocardial infarction, or any repeat revascularization. Results: After adjustment, in the pre-PCI TIMI 0/1 group, the cumulative incidence of all-cause death was higher in both prediabetes (adjusted hazard ratio [aHR]: 1.633, p = 0.045) and T2DM (aHR: 2.064, p = 0.002) groups than in the normoglycemia group. In the pre-PCI TIMI 2/3 group, the cumulative incidence of any repeat revascularization was higher in both prediabetes (aHR: 2.511, p = 0.039) and T2DM (aHR: 3.156, p = 0.009) groups than in the normoglycemia group. However, in each group (pre-PCI TIMI 0/1 or 2/3), the cumulative incidences of MACEs and all other clinical outcomes were not significantly different between the prediabetes and T2DM groups. Conclusions: In this retrospective registry study, prediabetes showed worse clinical outcomes similar to those of T2DM regardless of the pre-PCI TIMI flow grade. However, further studies are warranted to confirm these results.

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Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 98%

Section: Study De Nitions and Clinical Outcomesmentioning

confidence: 99%

Section: Study De Nitions and Clinical Outcomesmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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Impact of Pre-percutaneous Coronary Intervention Thrombolysis in Myocardial Infarction Flow Grade in Patients With ST-segment Elevation Myocardial Infarction and Prediabetes or Diabetes After Successful Newer-generation Drug-eluting Stent Implantation

Kim

Her

Jeong

et al. 2020

Preprint

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Effects of delayed hospitalization on the 3‐year clinical outcomes of patients with or without diabetes who had non‐ST‐segment‐elevation myocardial infarction and underwent new‐generation drug‐eluting stent implantation

Kim

Her

Rha

et al. 2023

Cathet Cardio Intervent

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Clinical outcomes after non‐ST‐segment‐elevation myocardial infarction (NSTEMI) in patients with (symptom‐to‐door time [SDT] ≥ 24 h) or without (SDT < 24 h) delayed hospitalization among patients with or without diabetes were compared. From the Korea Acute Myocardial Infarction Registry‐National Institute of Health, a total of 4517 patients with NSTEMI who underwent new‐generation drug‐eluting stents implantation were recruited and they were classified into the diabetes mellitus (DM) and non‐DM groups. These two groups were subdivided into groups with and without delayed hospitalization. The primary clinical outcome was the occurrence of major adverse cardiac and cerebrovascular events (MACCE), defined as all‐cause death, recurrent myocardial infarction, repeat coronary revascularization, and stroke. The secondary clinical outcome was the occurrence of individual components of MACCE and stent thrombosis. Although after multivariable and propensity score‐adjusted analyses in the DM group, the primary and secondary clinical outcomes between the SDT < 24 h and SDT ≥ 24 h groups were similar; in the non‐DM group, all‐cause (p = 0.003 and p = 0.007, respectively) and cardiac (p = 0.001 and p = 0.008, respectively) death rates were significantly higher in the SDT ≥ 24 h group than in the SDT < 24 h group. Our results suggested that there was no significant difference in prognosis between diabetic patients with and without delayed SDT, but delayed SDT was associated with poor prognosis in nondiabetic patients.

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Cardiovascular profiling in the diabetic continuum: results from the population-based Gutenberg Health Study

et al. 2021

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Aims To assess the prevalence of type 2 diabetes mellitus (T2DM) and prediabetes in the general population and to investigate the associated cardiovascular burden and clinical outcome. Methods and Results The study sample comprised 15,010 individuals aged 35–74 years of the population-based Gutenberg Health Study. Subjects were classified into euglycaemia, prediabetes and T2DM according to clinical and metabolic (HbA1c) information. The prevalence of prediabetes was 9.5% (n = 1415) and of T2DM 8.9% (n = 1316). Prediabetes and T2DM showed a significantly increased prevalence ratio (PR) for age, obesity, active smoking, dyslipidemia, and arterial hypertension compared to euglycaemia (for all, P < 0.0001). In a robust Poisson regression analysis, prediabetes was established as an independent predictor of clinically-prevalent cardiovascular disease (PRprediabetes 1.20, 95% CI 1.07–1.35, P = 0.002) and represented as a risk factor for asymptomatic cardiovascular organ damage independent of traditional risk factors (PR 1.04, 95% CI 1.01–1.08, P = 0.025). Prediabetes was associated with a 1.5-fold increased 10-year risk for cardiovascular disease compared to euglycaemia. In Cox regression analysis, prediabetes (HR 2.10, 95% CI 1.76–2.51, P < 0.0001) and T2DM (HR 4.28, 95% CI 3.73–4.92, P < 0.0001) indicated for an increased risk of death. After adjustment for age, sex and traditional cardiovascular risk factors, only T2DM (HR 1.89, 95% CI 1.63–2.20, P < 0.0001) remained independently associated with increased all-cause mortality. Conclusion Besides T2DM, also prediabetes inherits a significant cardiovascular burden, which translates into poor clinical outcome and indicates the need for new concepts regarding the prevention of cardiometabolic disorders.

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Effects of prediabetes on long-term clinical outcomes of patients with acute myocardial infarction who underwent PCI using new-generation drug-eluting stents

Cited by 18 publications

References 44 publications

Impact of Pre-percutaneous Coronary Intervention Thrombolysis in Myocardial Infarction Flow Grade in Patients With ST-segment Elevation Myocardial Infarction and Prediabetes or Diabetes After Successful Newer-generation Drug-eluting Stent Implantation

Impact of Pre-percutaneous Coronary Intervention Thrombolysis in Myocardial Infarction Flow Grade in Patients With ST-segment Elevation Myocardial Infarction and Prediabetes or Diabetes After Successful Newer-generation Drug-eluting Stent Implantation

Effects of delayed hospitalization on the 3‐year clinical outcomes of patients with or without diabetes who had non‐ST‐segment‐elevation myocardial infarction and underwent new‐generation drug‐eluting stent implantation

Cardiovascular profiling in the diabetic continuum: results from the population-based Gutenberg Health Study

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