TY - JOUR
T1 - Diabetic Patients Who Present With ST-Elevation Myocardial Infarction
AU - Megaly, Michael
AU - Schmidt, Christian W.
AU - Dworak, Marshall W.
AU - Garberich, Ross
AU - Stanberry, Larissa
AU - Sharkey, Scott
AU - Brilakis, Emmanouil S.
AU - Aguirre, Frank V.
AU - Pacheco, Roberto
AU - Tannenbaum, Mark
AU - Coulson, Teresa
AU - Smith, Timothy D.
AU - Henry, Timothy D.
AU - Garcia, Santiago
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/5
Y1 - 2022/5
N2 - Background: The long-term outcomes of diabetic patients presenting with ST-segment elevation myocardial infarction (STEMI) in contemporary practice have received limited study. Methods: We evaluated the clinical characteristics and outcomes of STEMI patients with and without diabetes in a large regional STEMI program designed to facilitate timely primary percutaneous coronary intervention (PCI) (Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, MN). The primary and secondary outcome measures were in-hospital mortality, 1-year major adverse cardiovascular events (MACE) (stroke, myocardial infarction, unplanned PCI or coronary artery bypass graft [CABG] surgery, and all-cause mortality), and 5-year mortality. Results: Of the 6292 patients included, 1158 (18.4%) had Diabetes Mellitus (DM) (95.3% Type II, 4.7% Type I). Patients with DM were older (mean age 66 vs. 62.8 years, p < 0.01), had more co-morbidities and were more likely to receive medical therapy without reperfusion (13% vs. 10%, p = 0.003). Patients with DM had higher in-hospital (8% vs. 5%, p = 0.001), 1-year (8% vs. 4%, p < 0.001) and 5-year mortality (16% vs. 9%, p < 0.001) compared to non-diabetics. On Cox proportional hazards analysis, DM was independently associated with worse mortality (hazard ratio: 1.70, 95% confidence interval (CI): 1.32–2.19, p < 0.001) and MACE [HR: 1.63 (95% (CI)): 1.28–2.08, p < 0.001]. Conclusions: Despite advancements in medical therapy and revascularization strategies for STEMI, DM remains independently associated with higher short- and long-term morbidity and mortality in contemporary practice.
AB - Background: The long-term outcomes of diabetic patients presenting with ST-segment elevation myocardial infarction (STEMI) in contemporary practice have received limited study. Methods: We evaluated the clinical characteristics and outcomes of STEMI patients with and without diabetes in a large regional STEMI program designed to facilitate timely primary percutaneous coronary intervention (PCI) (Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, MN). The primary and secondary outcome measures were in-hospital mortality, 1-year major adverse cardiovascular events (MACE) (stroke, myocardial infarction, unplanned PCI or coronary artery bypass graft [CABG] surgery, and all-cause mortality), and 5-year mortality. Results: Of the 6292 patients included, 1158 (18.4%) had Diabetes Mellitus (DM) (95.3% Type II, 4.7% Type I). Patients with DM were older (mean age 66 vs. 62.8 years, p < 0.01), had more co-morbidities and were more likely to receive medical therapy without reperfusion (13% vs. 10%, p = 0.003). Patients with DM had higher in-hospital (8% vs. 5%, p = 0.001), 1-year (8% vs. 4%, p < 0.001) and 5-year mortality (16% vs. 9%, p < 0.001) compared to non-diabetics. On Cox proportional hazards analysis, DM was independently associated with worse mortality (hazard ratio: 1.70, 95% confidence interval (CI): 1.32–2.19, p < 0.001) and MACE [HR: 1.63 (95% (CI)): 1.28–2.08, p < 0.001]. Conclusions: Despite advancements in medical therapy and revascularization strategies for STEMI, DM remains independently associated with higher short- and long-term morbidity and mortality in contemporary practice.
KW - DM
KW - Diabetes mellitus
KW - STEMI
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U2 - 10.1016/j.carrev.2021.08.003
DO - 10.1016/j.carrev.2021.08.003
M3 - Article
C2 - 34373234
AN - SCOPUS:85111997755
SN - 1553-8389
VL - 38
SP - 89
EP - 93
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
ER -