Two-Year Clinical Outcomes Between Prediabetic and Diabetic Patients With STEMI and Multivessel Disease Who Underwent Successful PCI Using Drug-Eluting Stents

Abstract

To evaluate clinical implication of prediabetes, we compared a 2-year major clinical outcome including patient-oriented composite outcomes (POCOs), stent thrombosis (ST), and stroke between prediabetes and diabetes in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD). A total of 4097 patients with STEMI and MVD (normoglycemia [group A: 1001], prediabetes [group B: 1518], and diabetes [group C: 1578]) who received drug-eluting stents were evaluated. Patient-oriented composite outcomes were defined as all-cause death, recurrent myocardial infarction (MI), or any repeat revascularization. The cumulative incidences of POCOs, ST, and stroke were similar between groups B and C. The cumulative incidences of all-cause death (adjusted hazard ratio [aHR]: 1.483; 95% CI: 1.027-2.143; P = .036) and all-cause death or MI (aHR: 1.429, 95% CI: 1.034-1.974; P = .031) were higher in group B than in group A. The cumulative incidences of all-cause death (aHR: 1.563; 95% CI: 1.089-2.243; P = .015), cardiac death (aHR: 1.661; 95% CI: 1.123-2.457; P = .011), and all-cause death or MI were higher in group C than in group A. In conclusion, prediabetes could potentially have a similar impact as diabetes on major clinical outcomes in patients with STEMI and MVD.

Comparative effect of statin intensity between prediabetes and type 2 diabetes mellitus after implanting newer-generation drug-eluting stents in Korean acute myocardial infarction patients: a retrospective observational study

“…Therefore, patients with prediabetes could show worse outcomes compared with those with normoglycemia. Hence, our results showing comparable clinical outcomes between the prediabetes and T2DM groups in both high-intensity and low-moderate-intensity statin users are consistent with recent reports [ 12 , 13 ]. According to a recent published report [ 41 ] after statin treatment, the cumulative incidences of MACE ( p = 0.314), all-cause death ( p = 0.530), cardiac death ( p = 0.873), Re-MI ( p = 0.170), and any repeat revascularization ( p = 0.548) were similar between the prediabetes and T2DM groups regardless of statin intensity.…”

“…Prediabetes is not an uncommon population to interventional cardiologists [ 11 ]. Recent studies reported that those with prediabetes had worse outcomes compared to normoglycemia and comparable to those with diabetes mellitus (DM) [ 12 , 13 ]. To reflect contemporary practice in Asian patients and to clarify the different effects of statin-intensity between prediabetes and type 2 DM (T2DM), in patients with AMI, we investigated a two-year clinical outcome in these two groups, especially in Korean AMI patients who underwent successful percutaneous coronary intervention (PCI) using newer-generation DES.…”

Comparative Effect of Statin Intensity Between Prediabetes and Type 2 Diabetes Mellitus After Implanting Newer-generation Drug-eluting Stents in Korean Acute Myocardial Infarction Patients: a Retrospective Observational Study

“…Therefore, patients with prediabetes could show worse outcomes compared with those with normoglycema and those with diabetes. Hence, our results showing comparable clinical outcomes between the prediabetes and T2DM groups in both high-intensity and low-moderate-intensity statin users are consistent with recent reports [12,13].…”

Risk of perioperative death and sudden cardiac arrest: A study of 113 456 cases from the National Registry of Invasive Cardiology Procedures (ORPKI) for estimation of the perioperative prognosis

“…The study showed a significantly higher all-cause and one-year mortality [18]. Recently, Kim et al [19] evaluated 4097 patients with STEMI and multi-vessel disease, diabetes, prediabetes, and normoglycemia. They revealed significantly higher mortality among patients with diabetes as compared to those with prediabetes and normoglycemia.…”