Outcomes in diabetic versus nondiabetic patients who present with acute myocardial infarction and are treated with drug-eluting stents.
Patients with diabetes mellitus (DM) are at a greater risk of mortality and cardiovascular events after percutaneous coronary intervention than those without DM. We aimed to determine whether differences exist in the long-term mortality of patients with versus without DM who present with acute myocardial infarction and receive drug-eluting stents. Data were collected on 161 patients with and 395 without DM referred for primary percutaneous coronary intervention for acute myocardial infarction and treated with drug-eluting stents. The patients with cardiac arrest or cardiogenic shock were excluded. The 1-year major cardiac event (MACE) rates, defined as death, Q-wave myocardial infarction, or target lesion revascularization, were compared between the 2 groups. The patients with DM were sicker at baseline. The MACE rates at 1 year were significantly increased in those with DM compared to those without DM. This was primarily driven by all-cause mortality. No differences in Q-wave myocardial infarction, target lesion revascularization, stent thrombosis, type of drug-eluting stents used, or procedure-related renal failure were seen. No differences were found in death or MACE rates at 1 year after adjusting for age, gender, race, systemic hypertension, peripheral artery disease, and a history of chronic renal failure between the 2 groups (weighted log-rank statistic, p = 0.37 and p = 0.37, respectively). In patients presenting with acute myocardial infarction, those with DM were sicker than those without DM. In conclusion, after correction for co-morbid conditions, no difference was seen in the 1-year MACE or death rates between those with and without DM who presented with acute myocardial infarction and were treated with drug-eluting stents.
Syed
Asmir I
AI
Department of Medicine, Division of Cardiology, Washington Hospital Center, Washington, District of Columbia.
Ben-Dor
Itsik
I
Li
Yanlin
Y
Collins
Sara D
SD
Gonzalez
Manuel A
MA
Gaglia
Michael A
MA
Maluenda
Gabriel
G
Delhaye
Cedric
C
Wakabayashi
Kohei
K
Bonello
Laurant
L
De Labriolle
Axel
A
Belle
Loic
L
Torguson
Rebecca
R
Xue
Zhenyi
Z
Kaneshige
Kimberly
K
Bernardo
Nelson
N
Satler
Lowell F
LF
Kent
Kenneth M
KM
Suddath
William O
WO
Pichard
Augusto D
AD
Lindsay
Joseph
J
Waksman
Ron
R
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D048909:Diabetes Complications; D054855:Drug-Eluting Stents; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D019233:Retreatment; D016896:Treatment Outcome