Key result
Insulin-treated diabetes linked to ~76% higher long-term mortality and MACE in STEMI patients with reduced EF.
Why the study?
ITDM and NITDM have different prognostic impacts in MI and/or heart failure, but their specific impact on long-term mortality and MACE in STEMI patients with reduced EF required analysis.
Does insulin-treated diabetes compared to non-insulin-treated diabetes or no diabetes affect long-term mortality and MACE in STEMI patients with reduced EF?
Cohort (n=2,230)
Does insulin-treated diabetes compared to non-insulin-treated diabetes or no diabetes affect long-term mortality and MACE in STEMI patients with reduced EF?
Answers are grounded in this paper and cite their sources.
Insulin-treated diabetes, but not non-insulin-treated diabetes, is an independent predictor of long-term mortality and MACE in patients with STEMI and reduced ejection fraction.
Background: Insulin- and non-insulin treated diabetes (ITDM and NITDM) have different prognostic impact in patients with myocardial infarction and/or heart failure. The aim of this study was to analyze the prognostic impact of ITDM and NTIDM on the incidence of all-cause mortality and major adverse cardiovascular events (MACE- cardiovascular death, nonfatal infarction, nonfatal stroke, and target vessel revascularization) in the 8-year follow-up of patients with ST-segment elevation myocardial infarction (STEMI) with a reduced ejection fraction (EF). Methods: We analyzed 2230 consecutive STEMI patients treated with primary percutaneous coronary intervention and with EF < 50%. Echocardiographic examination was performed after primary percutaneous coronary intervention . Patients were divided into 3three groups: those with ITDM, those with NITDM, and those with no DM. Patients presenting with cardiogenic shock were excluded. Results: < 0.001, respectively). Multivariable analysis showed ITDM to be an independent predictor for long-term mortality (hazard ratio 1.76, 95% confidence interval 1.15-2.69), and MACE (hazard ratio 1.72, 95% confidence interval 1.15-2.62). Conclusions: ITDM was an independent predictor of the occurrence of long-term mortality and MACE in patients with STEMI and reduced EF. NITDM was not an independent predictor for the occurrence of adverse events in analyzed patients.
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Savić et al. (2024) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) with reduced ejection fraction (n=2,230). Insulin-treated diabetes mellitus (ITDM) vs. Non-insulin-treated diabetes mellitus (NITDM) and no diabetes mellitus was evaluated on All-cause mortality and major adverse cardiovascular events (MACE- cardiovascular death, nonfatal infarction, nonfatal stroke, and target vessel revascularization) (HR 1.76, 95% CI 1.15-2.69). Insulin-treated diabetes was an independent predictor for long-term mortality (HR 1.76; 95% CI 1.15-2.69) and MACE (HR 1.72; 95% CI 1.15-2.62) in STEMI patients with reduced ejection fraction.
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