Abstract | BACKGROUND: METHODS: From December 2004 to March 2006, 56 consecutive diabetic patients (diabetic group) and 170 non-diabetic patients (non-diabetic group) with acute STEMI who underwent primary PCI with DES implantation in 3 hospitals were enrolled. Baseline clinical, angiographic, and procedural characteristics, as well as occurrence of major adverse cardiac event ( MACE) including cardiac death, non-fatal recurrent myocardial infarction (re-MI) and target vessel revascularization (TVR) during hospitalization and one-year clinical follow-up were compared between the two groups. RESULTS: Patients in diabetic group were more hyperlipidemic (69.6% and 51.8%, P = 0.03) and had longer time delay from symptom onset to admission ((364 +/- 219) minutes and (309 +/- 223) minutes, P = 0.02) than those in non-diabetic group. The culprit vessel distribution, reference vessel diameter, and baseline TIMI flow grade were similar between the two groups, but multi-vessel disease was more common in diabetic than in non-diabetic group (82.1% and 51.2%, P < 0.001). Despite similar TIMI flow grades between the two groups after stenting, the occurrence of TIMI myocardial perfusion grade ( TMPG) = 2 was lower in diabetic group (75.0% vs 88.8% in non-diabetic groups, P = 0.02). The MACE rate was similar during hospitalization between the two groups (5.4% vs 3.5%, P = 0.72), but it was significantly higher in diabetic group (16.1%) during one-year follow-up, as compared with non-diabetic group (6.5%, P = 0.03). The cumulative one-year MACE-free survival rate was significantly lower in diabetic than in non-diabetic group (78.6% vs 90.0%, P = 0.02). Angiographic stent thrombosis occurred in 5.4% and 1.2% of the patients in diabetic and non-diabetic group, respectively (P = 0.19). All of these patients experienced non-fatal myocardial infarction. CONCLUSIONS: Although the early clinical outcomes were similar in diabetic and non-diabetic patients with acute STEMI treated with DES implantation, the cumulative MACE-free survival at one-year follow-up was worse in diabetic than in non-diabetic patients. More effective diabetes-related managements may further improve the clinical outcomes of diabetic cohort suffering STEMI.
|
Authors | Qi Zhang, Jie Shen, Rui-yan Zhang, Jian-ping Qiu, Ji-de Lu, Yu Zhang, Yue-hua Chen, Jun-feng Zhang, Jian-sheng Zhang, Jian Hu, Zhen-Kun Yang, Ai-Fang Zheng, Xian Zhang, Wei-Feng Shen |
Journal | Chinese medical journal
(Chin Med J (Engl))
Vol. 120
Issue 21
Pg. 1862-7
(Nov 05 2007)
ISSN: 0366-6999 [Print] China |
PMID | 18067756
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
|
Topics |
- Aged
- Angioplasty, Balloon, Coronary
(adverse effects)
- Coronary Angiography
- Diabetes Complications
(physiopathology, therapy)
- Diabetes Mellitus
(pathology, physiopathology)
- Disease-Free Survival
- Drug-Eluting Stents
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(diagnostic imaging, physiopathology, therapy)
- Prospective Studies
- Treatment Outcome
|