title: Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization: Analysis of the prospective registry of DIAMOND (DIabetic acute myocardial infarctiON Disease) in Korea: an observational registry study.
abstract: This study assessed the 2-year clinical outcomes of patients with diabetes mellitus (DM) after acute myocardial infarction (AMI) in a cohort of the DIAMOND (DIabetic Acute Myocardial infarctiON Disease) registry. Clinical outcomes were compared between 1088 diabetic AMI patients in the DIAMOND registry after stabilization of MI and 1088 nondiabetic AMI patients from the KORMI (Korean AMI) registry after 1 : 1 propensity score matching using traditional cardiovascular risk factors. Stabilized patients were defined as patients who did not have any clinical events within 1 month after AMI. Primary outcomes were the 2-year rate of major adverse cardiac events (MACEs), a composite of all-cause death, recurrent MI (re-MI), and target vessel revascularization (TVR). Matched comparisons revealed that diabetic patients exhibited significantly lower left ventricular ejection fraction (LVEF) and estimated glomerular filtration rate and smaller stent size. Diabetic patients exhibited significantly higher 2-year rates of MACE (8.0% vs 3.7%), all-cause death (3.9% vs 1.4%), re-MI (2.8% vs 1.2%), and TVR (3.5% vs 1.3%) than nondiabetic patients (all P < 0.01), and higher cumulative rates in Kaplan-Meier analyses of MACE, all-cause death, and TVR (all P < 0.05). A multivariate Cox regression analysis revealed that chronic kidney disease, LVEF < 35%, and long stent were independent predictors of MACE, and large stent diameter and the use of drug-eluting stents were protective factors against MACE. The 2-year MACE rate beyond 1 month after AMI was significantly higher in DM patients than non-DM patients, and this rate was associated with higher comorbidities, coronary lesions, and procedural characteristics in DM.
authors.affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu Department of Internal Medicine, Konyang University Hospital, Daejeon Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam Department of Internal Medicine, Chonnam National University Hospital, Gwangju Department of Internal Medicine, Yeungnam University Hospital, Daegu Department of Internal Medicine, Seoul National University Hospital, Seoul Department of Internal Medicine, Sejong General Hospital, Bucheon Department of Internal Medicine, Yonsei University Severance Hospital, Seoul Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul Department of Internal Medicine, Kyungpook National University Hospital, Daegu Department of Internal Medicine, Ajou University Hospital, Suwon Department of Internal Medicine, Wonju Severance Christian Hospital, Wonju Department of Internal Medicine, Samsung Medical Center, Seoul Department of Internal Medicine, Korea University Guro Hospital, Seoul Department of Internal Medicine, Chungbuk National UniversityHospital, Cheongju Department of Internal Medicine, Korea University Anam Hospital, Seoul Department of Internal Medicine, Eulji University Hospital, Daejeon Department of Internal Medicine, Wonkwang University Hospital, Iksan Department of Internal Medicine, Chungnam National University Hospital, Daejeon Department of Internal Medicine, Ulsan University Hospital, Ulsan Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Hur
authors.forename: Ki-Bum
authors.initials: KB
authors.lastname: Won
authors.forename: In-Cheol
authors.initials: IC
authors.lastname: Kim
authors.forename: Jang-Ho
authors.initials: JH
authors.lastname: Bae
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Choi
authors.forename: Young-Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Jong-Seon
authors.initials: JS
authors.lastname: Park
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Rak-Kyeong
authors.initials: RK
authors.lastname: Choi
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Joon-Hong
authors.initials: JH
authors.lastname: Kim
authors.forename: Kyoo-Rok
authors.initials: KR
authors.lastname: Han
authors.forename: Hun-Sik
authors.initials: HS
authors.lastname: Park
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Choi
authors.forename: Jung-Han
authors.initials: JH
authors.lastname: Yoon
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Wooyeong
authors.initials: W
authors.lastname: Jang
authors.forename: Jang-Whan
authors.initials: JW
authors.lastname: Bae
authors.forename: Kyung-Kuk
authors.initials: KK
authors.lastname: Hwang
authors.forename: Do-Sun
authors.initials: DS
authors.lastname: Lim
authors.forename: Kyung-Tae
authors.initials: KT
authors.lastname: Jung
authors.forename: Seok-Kyu
authors.initials: SK
authors.lastname: Oh
authors.forename: Jae-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Shin
authors.forename: Kee-Sik
authors.initials: KS
authors.lastname: Kim
mesh_terms: D002423:Cause of Death / Q000639:trends; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D057216:Propensity Score; D011446:Prospective Studies; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome