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Primary coronary angioplasty in patients with ST segment elevation acute myocardial infarction and diabetes.
Kardiol Pol. 2004 Sep; 61(9):232-41; discussion 242.KP

Abstract

BACKGROUND

Subjects with diabetes constitute 13-25% of patients with ST segment elevation acute myocardial infarction (STEMI). In spite of the introduction of thrombolytic therapy, patients with STEMI and diabetes continue to have worse prognosis than those without diabetes. Primary percutaneous coronary intervention (PCI) has been shown in recent years to be the most effective therapy in patients with STEMI.

AIM

To compare the outcome of STEMI patients with or without diabetes who underwent primary PCI.

METHODS

The study group consisted of 500 consecutive patients with STEMI. The occurrence of major adverse cardiac events (MACE) which included death, reinfarction or repeated PCI of the target vessel, was analysed peri-operatively and during a six-month follow-up period.Results. Diabetes was diagnosed in 68 (13.6%) patients. The mean time duration from the onset of STEMI symptoms to treatment was similar in patients with or without diabetes (230+/-97 min vs 231+/-139 min, NS). Patients with diabetes were older (61.9+/-8.9 vs 57.9+/-10.8 years, p=0.004), had higher body mass index (29+/-4 vs 27+/-5, p=0.002), more frequent history of coronary artery disease (57.4% vs 37.9%, p=0.002), higher prevalence of arterial hypertension (71.6% vs 56.8%, p=0.02) and more frequently the left anterior descending artery as the infarct-related artery (58.8% vs 42.1%, p=0.01). Immediately after PCI, epicardial and myocardial reperfusion rates were lower in patients with rather than without diabetes (TIMI 3: 84.9% vs 91.3%, p=NS, cTFC: 32+/-26 vs 22+/-16, p<0.0001, and MPG3: 25% vs 41.9% p=0.008). Diabetes increased the risk of MACE during in-hospital period by 2.7 times. The rate of MACE during a six-month follow-up period was almost two times higher in patients with rather than without diabetes (death: 8.8% vs 5.1%, reinfarction: 1.5% vs 1.2%, repeated PCI: 11.8% vs 6.9%).

CONCLUSIONS

Primary PCI-achieved epicardial and myocardial reperfusion rate is lower in STEMI patients with rather than without diabetes. The presence of diabetes almost doubles the risk of MACE during a six-month follow-up.

Authors+Show Affiliations

Department of Hemodynamics and Angiocardiography, Institute of Cardiology, Jagiellonian University, College of Medicine, Cracow, Poland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng pol

PubMed ID

15531935

Citation

Dudek, Dariusz, et al. "Primary Coronary Angioplasty in Patients With ST Segment Elevation Acute Myocardial Infarction and Diabetes." Kardiologia Polska, vol. 61, no. 9, 2004, pp. 232-41; discussion 242.
Dudek D, Mielecki W, Wizimirski M, et al. Primary coronary angioplasty in patients with ST segment elevation acute myocardial infarction and diabetes. Kardiol Pol. 2004;61(9):232-41; discussion 242.
Dudek, D., Mielecki, W., Wizimirski, M., Rakowski, T., Dziewierz, A., Sorysz, D., Tomala, M., Zorkun, C., Zmudka, K., & Dubiel, J. S. (2004). Primary coronary angioplasty in patients with ST segment elevation acute myocardial infarction and diabetes. Kardiologia Polska, 61(9), 232-41; discussion 242.
Dudek D, et al. Primary Coronary Angioplasty in Patients With ST Segment Elevation Acute Myocardial Infarction and Diabetes. Kardiol Pol. 2004;61(9):232-41; discussion 242. PubMed PMID: 15531935.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary coronary angioplasty in patients with ST segment elevation acute myocardial infarction and diabetes. AU - Dudek,Dariusz, AU - Mielecki,Waldemar, AU - Wizimirski,Marcin, AU - Rakowski,Tomasz, AU - Dziewierz,Artur, AU - Sorysz,Danuta, AU - Tomala,Marek, AU - Zorkun,Cafer, AU - Zmudka,Krzysztof, AU - Dubiel,Jacek S, PY - 2004/11/9/pubmed PY - 2005/3/9/medline PY - 2004/11/9/entrez SP - 232-41; discussion 242 JF - Kardiologia polska JO - Kardiol Pol VL - 61 IS - 9 N2 - BACKGROUND: Subjects with diabetes constitute 13-25% of patients with ST segment elevation acute myocardial infarction (STEMI). In spite of the introduction of thrombolytic therapy, patients with STEMI and diabetes continue to have worse prognosis than those without diabetes. Primary percutaneous coronary intervention (PCI) has been shown in recent years to be the most effective therapy in patients with STEMI. AIM: To compare the outcome of STEMI patients with or without diabetes who underwent primary PCI. METHODS: The study group consisted of 500 consecutive patients with STEMI. The occurrence of major adverse cardiac events (MACE) which included death, reinfarction or repeated PCI of the target vessel, was analysed peri-operatively and during a six-month follow-up period.Results. Diabetes was diagnosed in 68 (13.6%) patients. The mean time duration from the onset of STEMI symptoms to treatment was similar in patients with or without diabetes (230+/-97 min vs 231+/-139 min, NS). Patients with diabetes were older (61.9+/-8.9 vs 57.9+/-10.8 years, p=0.004), had higher body mass index (29+/-4 vs 27+/-5, p=0.002), more frequent history of coronary artery disease (57.4% vs 37.9%, p=0.002), higher prevalence of arterial hypertension (71.6% vs 56.8%, p=0.02) and more frequently the left anterior descending artery as the infarct-related artery (58.8% vs 42.1%, p=0.01). Immediately after PCI, epicardial and myocardial reperfusion rates were lower in patients with rather than without diabetes (TIMI 3: 84.9% vs 91.3%, p=NS, cTFC: 32+/-26 vs 22+/-16, p<0.0001, and MPG3: 25% vs 41.9% p=0.008). Diabetes increased the risk of MACE during in-hospital period by 2.7 times. The rate of MACE during a six-month follow-up period was almost two times higher in patients with rather than without diabetes (death: 8.8% vs 5.1%, reinfarction: 1.5% vs 1.2%, repeated PCI: 11.8% vs 6.9%). CONCLUSIONS: Primary PCI-achieved epicardial and myocardial reperfusion rate is lower in STEMI patients with rather than without diabetes. The presence of diabetes almost doubles the risk of MACE during a six-month follow-up. SN - 0022-9032 UR - https://www.unboundmedicine.com/medline/citation/15531935/Primary_coronary_angioplasty_in_patients_with_ST_segment_elevation_acute_myocardial_infarction_and_diabetes_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -