Primary coronary angioplasty in patients with ST segment elevation acute myocardial infarction and diabetes
Abstract
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.
Abstract
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.
Keywords
percutaneous coronary intervention - acute myocardial infarction - diabetes


Title
Primary coronary angioplasty in patients with ST segment elevation acute myocardial infarction and diabetes
Journal
Kardiologia Polska (Polish Heart Journal)
Issue
Pages
238-241
Published online
2005-12-12
Bibliographic record
Kardiol Pol 2004;61(9):238-241.
Keywords
percutaneous coronary intervention - acute myocardial infarction - diabetes
Authors
Dariusz Dudek
Waldemar Mielecki
Marcin Wizimirski
Tomasz Rakowski
Artur Dziewierz
Danuta Sorysz
Marek Tomala
Cafer Zorkun
Krzysztof Żmudka
Jacek Dubiel