Key result
Diabetes was not significantly associated with the rate of ST segment resolution ≥ 50% at 90 minutes following streptokinase therapy for STEMI (48.7% vs 45.1%, p=0.1).
Why the study?
Does diabetes affect ST segment resolution and short-term clinical outcomes in patients with acute STEMI following fibrinolytic therapy?
Cohort (n=275)
No
Does diabetes affect ST segment resolution and short-term clinical outcomes in patients with acute STEMI following fibrinolytic therapy?
Absolute Event Rate: 48.7% vs 45.1%
p-value: p=0.1
In patients with STEMI treated with streptokinase, diabetes does not independently impair ST-segment resolution or short-term clinical outcomes after adjusting for baseline risk factors.
Diabetes should not guide streptokinase expectations in STEMI; leaves open glycemic effects on reperfusion.
CĂl: Zjistit souvislost mezi diabetem na jednĂŠ stranÄ a kvalitou rozliĹĄenĂ zobrazenĂ segmentu ST a klinickĂŠho vĂ˝sledku na stranÄ druhĂŠ, po fibrinolĂ˝ze u pacientĹŻ po prvnĂm infarktu myokardu s elevacĂ segmentu ST (ST elevation myocardial infarction, STEMI).Metody a vĂ˝sledky: ProspektivnÄ se shromaĹžÄovaly klinickĂŠ Ăşdaje 275 po sobÄ nĂĄsledujĂcĂch pacientĹŻ po prvnĂm STEMI, jimĹž byla do ĹĄesti hodin po nĂĄstupu bolesti na hrudi podĂĄna streptokinĂĄza. RozliĹĄenĂ segmentu ST ≥ 50 % v dobÄ 90 minut po fibrinolĂ˝ze bylo povaĹžovĂĄno za znĂĄmku ĂşspÄĹĄnĂŠ reperfuze. Souvislost diabetu s rizikem neĂşspÄĹĄnĂŠ reperfuze, rozvojem srdeÄnĂho selhĂĄnĂ a nemocniÄnĂ mortalitou byla hodnocena pĹed adjustacĂ na dalĹĄĂ rizikovĂŠ faktory postiĹženĂ koronĂĄrnĂch tepen a po nĂ.RozliĹĄenĂ segmentu ST ≥ 50 % bylo pĹĂtomno u 45,1 % nediabetikĹŻ a 48,7 % diabetikĹŻ (p = 0,1). SrdeÄnĂ selhĂĄnĂ bylo ÄastÄjĹĄĂ a nemocniÄnĂ mortalita vyĹĄĹĄĂ u diabetikĹŻ (25,7 % vs. 14,8 %; p = 0,03, resp. 17,8 % vs. 8,4 %; p = 0,03). U diabetikĹŻ existovala vyĹĄĹĄĂ pravdÄpodobnost koronarografickĂŠho prĹŻkazu postiĹženĂ tĹĂ cĂŠv (23 % vs. 8 %; p < 0,001). Po adjustaci na vstupnĂ charakteristiky nebyl diabetes nezĂĄvisle spojen s neĂşspÄĹĄnou reperfuzĂ ani zĂĄvaĹžnĂ˝mi srdeÄnĂmi pĹĂhodami vÄetnÄ srdeÄnĂho selhĂĄnĂ a nemocniÄnĂ mortality.ZĂĄvÄry: Kvalita rozliĹĄenĂ segmentu ST nenĂ pĹĂpadnou pĹĂtomnostĂ diabetu ovlivnÄna. I kdyĹž u diabetikĹŻ byla popsĂĄna vyĹĄĹĄĂ prevalence srdeÄnĂho selhĂĄnĂ a nemocniÄnĂ mortality po lĂŠÄbÄ STEMI streptokinĂĄzou, jejich nepĹĂznivĂĄ prognĂłza je nejspĂĹĄe dĹŻsledkem vyĹĄĹĄĂ zĂĄtÄĹže dalĹĄĂmi rizikovĂ˝mi faktory postiĹženĂ koronĂĄrnĂch tepen.
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Pourmousavi et al. (2015) conducted a cohort in ST elevation myocardial infarction (STEMI) (n=275). Diabetes vs. Non-diabetics was evaluated on ST segment resolution ≥ 50% at 90 minutes after fibrinolysis (p=0.1). Diabetes was not significantly associated with the rate of ST segment resolution ≥ 50% at 90 minutes following streptokinase therapy for STEMI (48.7% vs 45.1%, p=0.1).
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