Key result
Prediabetes linked to ~29% higher MACE risk vs. normoglycemia in post-PCI AMI patients on statins.
Why the study?
Studies comparing long-term clinical outcomes of statin treatment between AMI patients with prediabetes and those with T2DM after successful PCI with newer-generation DESs are limited.
Does prediabetes increase the risk of MACE compared to normoglycemia in statin-treated acute myocardial infarction patients?
Cohort (n=11,962)
Yes
Does prediabetes increase the risk of MACE compared to normoglycemia in statin-treated acute myocardial infarction patients?
Hazard Ratio: 1.288 (95% CI 1.033–1.606)
Absolute Event Rate: 6.9% vs 5.4%
p-value: p=0.025
In AMI patients treated with statins, prediabetes confers a cardiovascular risk similar to T2DM, underscoring the need for aggressive secondary prevention in this group.
Prediabetes signals elevated MACE risk comparable to T2DM in statin-treated AMI post-PCI; leaves open whether glycemic interventions alter outcomes.
Studies comparing long-term clinical outcomes of statin treatment between acute myocardial infarction (AMI) patients with prediabetes and those with type 2 diabetes mellitus (T2DM) after successful percutaneous coronary intervention (PCI) with the newer-generation drug-eluting stents (DESs) are limited. We compared 2-year clinical outcomes between these patients.A total of 11,962 AMI patients were classified as statin users (n = 10,243) and statin nonusers (n = 1719). Thereafter, statin users and nonusers were further divided into the normoglycemia, prediabetes, and T2DM groups. The major outcome was the occurrence of major adverse cardiac event (MACE) defined as all-cause death, recurrent myocardial infarction (Re-MI), or any repeat coronary revascularization.After statin treatment, the cumulative incidences of MACE (P = .314), all-cause death, cardiac death (CD), Re-MI, and any repeat revascularization were similar between the prediabetes and T2DM groups. However, the cumulative incidences of MACE (P = .025) and all-cause death (P = .038) in the prediabetes group and those of MACE (P = .001), all-cause death (P = .009), and CD (P = .048) in the T2DM group were significantly higher than those in the normoglycemia group. Moreover, in all the 3 glycemic groups, the cumulative incidences of MACE, all-cause death, and CD were significantly higher among statin nonusers than among statin users.This study revealed that AMI patients with prediabetes had worse clinical outcomes than those with normoglycemia and comparable to those with T2DM after 2-year statin treatment. However, further studies are warranted to confirm the current findings.
No takes yet. Share an insight, caveat, or question.
Kim et al. (2021) conducted a cohort in Acute myocardial infarction (n=11,962). Prediabetes vs. Normoglycemia was evaluated on Major adverse cardiac event (MACE) (aHR 1.288, 95% CI 1.033-1.606, p=0.025). Among statin-treated AMI patients following PCI, prediabetes was associated with a higher risk of MACE compared to normoglycemia (aHR 1.288) and had a risk comparable to T2DM.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: