Key result
Diabetes mellitus in patients presenting with STEMI was associated with a higher frequency of multi-vessel disease (50.9% vs 39.6%) and more hemodynamic instability compared to non-diabetic patients.
Why the study?
Differences in clinical and angiographic profiles of STEMI patients with and without diabetes mellitus undergoing primary PCI needed evaluation.
Do clinical and angiographic characteristics differ between diabetic and non-diabetic patients presenting with STEMI undergoing primary PCI?
Cross-Sectional (n=498)
No
Do clinical and angiographic characteristics differ between diabetic and non-diabetic patients presenting with STEMI undergoing primary PCI?
Absolute Event Rate: 50.9% vs 39.6%
p-value: p=0.041
Diabetes in patients with STEMI is associated with more complex coronary artery disease, greater hemodynamic instability, and higher comorbidity burden compared to non-diabetic patients.
May inform risk stratification in diabetic STEMI; leaves open optimal management strategies pending prospective trials.
Objectives: In this study, we evaluated the differences in clinical and angiographic profiles of ST-segment elevation myocardial infarction (STEMI) patients with and without diabetes mellitus (DM) at a tertiary care cardiac hospital in Karachi, Pakistan. Methodology: This descriptive cross-sectional study was conducted at a tertiary care cardiac hospital in Karachi, Pakistan. The study included consecutive adult patients (≥ 18 years of age) diagnosed with STEMI undergoing primary percutaneous coronary intervention (PCI). Diabetic and non-diabetic patients were compared for clinical and angiographic profiles. Results: The study sample consisted of 43.8% (218) diabetic patients. The mean age was 59.03 ± 9.69 years vs. 49.54 ± 11.53 years; p<0.001, proportion of females was 35.3% (77) vs. 14.6% (41); p<0.001, Killip class III or IV was (17) vs. 2.5% (7), and hypertension was 83% (181) vs. 56.8% (159); p<0.001 among the diabetic and non-diabetic group, respectively. The frequency of multi-vessel disease was 50.9% (111) vs. 39.6% (111), the significant left main disease was 5% (11) vs. 2.5% (7), and initial TIMI III flow was 19.3% (42) vs. 25.4% (71) in diabetic and non-diabetic patients, respectively. Conclusion: In conclusion, diabetes in STEMI setting is associated with complex coronary artery diseases, more hemodynamic instability at presentation, and the presence of multiple co-morbid conditions.
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Ahmed et al. (2022) conducted a cross-sectional in ST-segment elevation myocardial infarction (STEMI) (n=498). Diabetes mellitus vs. Non-diabetic was evaluated on Multi-vessel disease (p=0.041). Diabetes mellitus in patients presenting with STEMI was associated with a higher frequency of multi-vessel disease (50.9% vs 39.6%) and more hemodynamic instability compared to non-diabetic patients.
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