Key result
Diabetes does not independently predict 3-year mortality after primary PCI for STEMI.
Why the study?
Does diabetes mellitus impact 3-year survival in patients with STEMI treated with primary PCI?
Cohort (n=499)
No
Does diabetes mellitus impact 3-year survival in patients with STEMI treated with primary PCI?
Hazard Ratio: 1.275 (95% CI 0.652–2.494)
Absolute Event Rate: 21.7% vs 10.6%
p-value: p=0.478
Although STEMI patients with diabetes have higher unadjusted mortality after primary PCI, diabetes may not be an independent predictor of 3-year mortality when adjusting for other baseline risk factors.
DM may not independently predict 3-year mortality after STEMI PCI; leaves open whether comorbidities drive excess risk and requires prospective confirmation.
Introduction: Primary percutaneous coronary intervention (PPCI) is a gold standard in treating patients with acute myocardial infarction (AMI) with ST Elevation Myocardial Infarction (STEMI). Aim: The aim of this study is to evaluate the impact of diabetic status three year survival in patients with STEMI treated with PPCI on admission. Material and methods: We analyzed 499 STEMI patients treated with primary PCI, from a prospective, electronic database of the Clinical Center of Serbia Catheterization Laboratory -that contains patient records from 2009 to 2016. Patients were divided into 2 groups: patients with diabetes mellitus (DM) and those without DM. Results: Our results showed that 416 (83,4%) patients did not have DM and 83 (16,6%) had DM. There was a statistically significant difference in mortality rate among two groups after 30 days and 3 years after intervention (DM 13,3% vs without DM 4,1%, p=0,003 after 30 days; DM 21,7% vs without DM 10,6%, p=0,010 after 3 years). However, when adjusted for other baseline risk factors, DM was not an independent predictor of 3-year mortality (HR=1,275, 95% CI 0,652-2,494, p=0,478). Conclusion: Patients with DM had higher mortality rates in both short-term and long-term follow-ups after PPCI.
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Radomirovic et al. (2017) conducted a cohort in ST-Elevation Myocardial Infarction (STEMI) (n=499). Diabetes mellitus vs. Without diabetes mellitus was evaluated on 3-year mortality (HR 1.275, 95% CI 0.652-2.494, p=0.478). Although patients with diabetes mellitus had higher unadjusted 3-year mortality after primary PCI for STEMI (21.7% vs 10.6%), diabetes was not an independent predictor of mortality when adjusted for other risk factors (HR 1.275).
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