PMID- 15531935
OWN - NLM
STAT- MEDLINE
DCOM- 20050308
LR  - 20101118
IS  - 0022-9032 (Print)
IS  - 0022-9032 (Linking)
VI  - 61
IP  - 9
DP  - 2004 Sep
TI  - Primary coronary angioplasty in patients with ST segment elevation acute 
      myocardial infarction and diabetes.
PG  - 232-41; discussion 242
AB  - BACKGROUND: Subjects with diabetes constitute 13-25% of patients with ST segment 
      elevation acute myocardial infarction (STEMI). In spite of the introduction of 
      thrombolytic therapy, patients with STEMI and diabetes continue to have worse 
      prognosis than those without diabetes. Primary percutaneous coronary intervention 
      (PCI) has been shown in recent years to be the most effective therapy in patients 
      with STEMI. AIM: To compare the outcome of STEMI patients with or without 
      diabetes who underwent primary PCI. METHODS: The study group consisted of 500 
      consecutive patients with STEMI. The occurrence of major adverse cardiac events 
      (MACE) which included death, reinfarction or repeated PCI of the target vessel, 
      was analysed peri-operatively and during a six-month follow-up period.Results. 
      Diabetes was diagnosed in 68 (13.6%) patients. The mean time duration from the 
      onset of STEMI symptoms to treatment was similar in patients with or without 
      diabetes (230+/-97 min vs 231+/-139 min, NS). Patients with diabetes were older 
      (61.9+/-8.9 vs 57.9+/-10.8 years, p=0.004), had higher body mass index (29+/-4 vs 
      27+/-5, p=0.002), more frequent history of coronary artery disease (57.4% vs 
      37.9%, p=0.002), higher prevalence of arterial hypertension (71.6% vs 56.8%, 
      p=0.02) and more frequently the left anterior descending artery as the 
      infarct-related artery (58.8% vs 42.1%, p=0.01). Immediately after PCI, 
      epicardial and myocardial reperfusion rates were lower in patients with rather 
      than without diabetes (TIMI 3: 84.9% vs 91.3%, p=NS, cTFC: 32+/-26 vs 22+/-16, 
      p<0.0001, and MPG3: 25% vs 41.9% p=0.008). Diabetes increased the risk of MACE 
      during in-hospital period by 2.7 times. The rate of MACE during a six-month 
      follow-up period was almost two times higher in patients with rather than without 
      diabetes (death: 8.8% vs 5.1%, reinfarction: 1.5% vs 1.2%, repeated PCI: 11.8% vs 
      6.9%). CONCLUSIONS: Primary PCI-achieved epicardial and myocardial reperfusion 
      rate is lower in STEMI patients with rather than without diabetes. The presence 
      of diabetes almost doubles the risk of MACE during a six-month follow-up.
FAU - Dudek, Dariusz
AU  - Dudek D
AD  - Department of Hemodynamics and Angiocardiography, Institute of Cardiology, 
      Jagiellonian University, College of Medicine, Cracow, Poland.
FAU - Mielecki, Waldemar
AU  - Mielecki W
FAU - Wizimirski, Marcin
AU  - Wizimirski M
FAU - Rakowski, Tomasz
AU  - Rakowski T
FAU - Dziewierz, Artur
AU  - Dziewierz A
FAU - Sorysz, Danuta
AU  - Sorysz D
FAU - Tomala, Marek
AU  - Tomala M
FAU - Zorkun, Cafer
AU  - Zorkun C
FAU - Zmudka, Krzysztof
AU  - Zmudka K
FAU - Dubiel, Jacek S
AU  - Dubiel JS
LA  - eng
LA  - pol
PT  - Comparative Study
PT  - Journal Article
PL  - Poland
TA  - Kardiol Pol
JT  - Kardiologia polska
JID - 0376352
SB  - IM
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Coronary Angiography
MH  - Diabetes Mellitus, Type 1/*complications
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Electrocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Conduction System/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*complications/physiopathology/*therapy
MH  - Treatment Outcome
EDAT- 2004/11/09 09:00
MHDA- 2005/03/09 09:00
CRDT- 2004/11/09 09:00
PHST- 2004/11/09 09:00 [pubmed]
PHST- 2005/03/09 09:00 [medline]
PHST- 2004/11/09 09:00 [entrez]
PST - ppublish
SO  - Kardiol Pol. 2004 Sep;61(9):232-41; discussion 242.