title: Outcomes in diabetic versus nondiabetic patients who present with acute myocardial infarction and are treated with drug-eluting stents.
abstract: 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.
authors.affiliation: Department of Medicine, Division of Cardiology, Washington Hospital Center, Washington, District of Columbia.
authors.forename: Asmir I
authors.initials: AI
authors.lastname: Syed
authors.forename: Itsik
authors.initials: I
authors.lastname: Ben-Dor
authors.forename: Yanlin
authors.initials: Y
authors.lastname: Li
authors.forename: Sara D
authors.initials: SD
authors.lastname: Collins
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Gonzalez
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gaglia
authors.forename: Gabriel
authors.initials: G
authors.lastname: Maluenda
authors.forename: Cedric
authors.initials: C
authors.lastname: Delhaye
authors.forename: Kohei
authors.initials: K
authors.lastname: Wakabayashi
authors.forename: Laurant
authors.initials: L
authors.lastname: Bonello
authors.forename: Axel
authors.initials: A
authors.lastname: De Labriolle
authors.forename: Loic
authors.initials: L
authors.lastname: Belle
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.forename: Zhenyi
authors.initials: Z
authors.lastname: Xue
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kaneshige
authors.forename: Nelson
authors.initials: N
authors.lastname: Bernardo
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Kent
authors.forename: William O
authors.initials: WO
authors.lastname: Suddath
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.forename: Joseph
authors.initials: J
authors.lastname: Lindsay
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: 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