Key result
In patients presenting with STEMI, the presence of both diabetes and hypertension was associated with a higher risk of left main stem disease compared to those without these conditions.
Why the study?
The study was conducted to determine the association of left main stem disease with diabetes and hypertension in STEMI patients undergoing coronary angiography.
Does the presence of diabetes and hypertension increase the risk of left main stem disease in patients presenting with STEMI?
Cohort (n=220)
No
Does the presence of diabetes and hypertension increase the risk of left main stem disease in patients presenting with STEMI?
The presence of concurrent diabetes and hypertension in STEMI patients is associated with a 3.5-fold increased risk of having left main stem disease on angiography.
Answers are grounded in this paper and cite their sources.
Associated with higher LMS risk in STEMI; hypothesis-generating and requires prospective validation before practice change.
Aim: To determine the association of left main stem disease with diabetes and hypertension in STEMI patients underwent coronary angiography Methodology: This study was conducted at Department of Cardiology, Sheikh Zayed Hospital, Lahore during January to June 2019 where 220 patients with age ranging from 40-70 years whether male or female, presenting with STEMI, In Exposed Group: Patients presenting with STEMI having diabetes and hypertension and Unexposed Group: Patients of STEMI without diabetes and hypertension. We excluded all cases with recurrent MI or undergoing recurrent PCI (on medical record), valvular heart disease, and cardiogenic shock. Then two groups were formed i.e. exposed group with diabetes and hypertension and unexposed group without diabetes and hypertension. All patients underwent angiography by a senior consultant cardiologist with assistance of researcher. On angiography, presence of LMS disease was ≥50% occlusion (stenosis) in LMS artery. Angiography reports were assessed and LMS disease was noted labeled. Patients with LMS disease was managed as per hospital protocol. Results: In this study risk of LMS was higher among exposed group as compared to un exposed group. i.e. exposed: 19.1% & Unexposed: 5.5%, RR=3.50 The risk of LMS among exposed group was higher for patients in the age group 51-60 years (RR=8.00), for male patients (RR=5.76) risk for LMS was higher as compared to female patients in exposed group, patients with normal BMI (RR:2.20) and patients with shorter duration of STEMI in exposed group had higher risk for LMS (1-4 weeks: RR=7.54). Conclusion: Results of this study showed that hypertensive and diabetic patients presenting with STEMI had higher risk for LMS disease.
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Ali et al. (2021) conducted a cohort in ST-Elevation Myocardial Infarction (STEMI) (n=220). Diabetes and hypertension vs. Without diabetes and hypertension was evaluated on Presence of left main stem (LMS) disease (≥50% stenosis) (RR 3.50, 95% CI 1.46-8.33, p=0.004). In patients presenting with STEMI, the presence of both diabetes and hypertension was associated with a higher risk of left main stem disease compared to those without these conditions.
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