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Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization

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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.

No MeSH data available.


Kaplan–Meier curves for the primary and secondary outcomes according to DM in the propensity score matched population. Cumulative incidence curves are shown for (A) MACE, (B) all-cause death, (C) re-MI, (D) TVR, and (E) ST.
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Figure 2: Kaplan–Meier curves for the primary and secondary outcomes according to DM in the propensity score matched population. Cumulative incidence curves are shown for (A) MACE, (B) all-cause death, (C) re-MI, (D) TVR, and (E) ST.

Mentions: The rates of MACE (8.0% vs 3.7%; P < 0.01), all-cause death (3.9 vs 1.4; P < 0.001), re-MI (2.8% vs 1.2%; P < 0.01), and TVR (3.5% vs 1.3%; P < 0.01) were also significantly higher in DM than non-DM patients with AMI, respectively. However, the rate of ST (0.9% vs 0.5%, P = 0.20) was comparable (Table 3). Kaplan–Meier survival analysis revealed that the cumulative incidences of MACE, all-cause death, and TVR were significantly higher in DM patients than non-DM patients (all P < 0.05). However, the cumulative incidences of re-MI and ST were not significantly different between DM and non-DM patients (Fig. 2, A–E).


Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization
Kaplan–Meier curves for the primary and secondary outcomes according to DM in the propensity score matched population. Cumulative incidence curves are shown for (A) MACE, (B) all-cause death, (C) re-MI, (D) TVR, and (E) ST.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998313&req=5

Figure 2: Kaplan–Meier curves for the primary and secondary outcomes according to DM in the propensity score matched population. Cumulative incidence curves are shown for (A) MACE, (B) all-cause death, (C) re-MI, (D) TVR, and (E) ST.
Mentions: The rates of MACE (8.0% vs 3.7%; P < 0.01), all-cause death (3.9 vs 1.4; P < 0.001), re-MI (2.8% vs 1.2%; P < 0.01), and TVR (3.5% vs 1.3%; P < 0.01) were also significantly higher in DM than non-DM patients with AMI, respectively. However, the rate of ST (0.9% vs 0.5%, P = 0.20) was comparable (Table 3). Kaplan–Meier survival analysis revealed that the cumulative incidences of MACE, all-cause death, and TVR were significantly higher in DM patients than non-DM patients (all P < 0.05). However, the cumulative incidences of re-MI and ST were not significantly different between DM and non-DM patients (Fig. 2, A–E).

View Article: PubMed Central - PubMed

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&#8202;:&#8202;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&#8202;&lt;&#8202;0.01), and higher cumulative rates in Kaplan&ndash;Meier analyses of MACE, all-cause death, and TVR (all P&#8202;&lt;&#8202;0.05). A multivariate Cox regression analysis revealed that chronic kidney disease, LVEF&#8202;&lt;&#8202;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.

No MeSH data available.