PMID- 29308090
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 1758-5996 (Print)
IS  - 1758-5996 (Electronic)
IS  - 1758-5996 (Linking)
VI  - 10
DP  - 2018
TI  - Effects of incretin treatment on cardiovascular outcomes in diabetic 
      STEMI-patients with culprit obstructive and multivessel non 
      obstructive-coronary-stenosis.
PG  - 1
LID - 10.1186/s13098-017-0304-3 [doi]
LID - 1
AB  - BACKGROUND: No proper data on prognosis and management of type-2 diabetic ST 
      elevation myocardial infarction (STEMI) patients with culprit obstructive lesion 
      and multivessel non obstructive coronary stenosis (Mv-NOCS) exist. We evaluated 
      the 12-months prognosis of Mv-NOCS-diabetics with first STEMI vs.to 
      non-diabetics, and then Mv-NOCS-diabetics previously treated with incretin based 
      therapy vs. a matched cohort of STEMI-Mv-NOCS never treated with such therapy. 
      METHODS: 1088 Patients with first STEMI and Mv-NOCS were scheduled for the study. 
      Patients included in the study were categorized in type 2 diabetics (n 292) and 
      non-diabetics (n 796). Finally, we categorized diabetics in 
      current-incretin-users (n 76), and never-incretin-users (n 180). The primary end 
      point was all cause deaths, cardiac deaths, and major adverse cardiac events 
      (MACE) at 12 months of follow up. RESULTS: The study results evidenced higher 
      percentage of all cause deaths (2.2% vs. 1.1%, p value 0.05), cardiac deaths 
      (1.6% vs. 0.5%, p value 0.045), and MACE (12.9% vs. n 5.9%), p value 0.001) in 
      diabetic vs. no diabetic patients at 12 months follow up. Among diabetic 
      patients, the current vs never-incretin-users, did not present a significant 
      difference about all cause of deaths, and cardiac deaths through 12-months. The 
      MACE rate at 1 year was 7.4% in diabetic incretin-users STEMI Mv-NOCS patients 
      vs. 12.9% in diabetic never-incretin-users STEMI-Mv-NOCS patients (p value 0.04). 
      In a risk-adjusted hazard analysis, MACE through 12 months were lower in diabetic 
      STEMI-Mv NOCS incretin-users vs never-incretin-users patients (HR 0.513, CI 
      [0.292-0.899], p 0.021). Consequently, lower levels of glucagon-like peptide 
      1(GLP-1) were predictive of MACE at follow up (HR 1.528, CI [1.059-2.204], p 
      0.024). CONCLUSION: In type 2 diabetic patients with STEMI-Mv-NOCS, we observed 
      higher incidence of 1-year mortality and adverse cardiovascular outcomes, as 
      compared to non-diabetic STEMI-Mv-NOCS patients. In diabetic patients, 
      never-incretin-users have worse prognosis as compared to 
      current-incretin-users.Trail registration Clinical trial number: NCT03312179, 
      name of registry: clinicaltrialgov, URL: clinicalltrialgov.com, date of 
      registration: September 2017, date of enrollment first participant: September 
      2009.
FAU - Marfella, Raffaele
AU  - Marfella R
AD  - Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, 
      Universita degli Studi della Campania "Luigi Vanvitelli", Caserta, Italy. ISNI: 
      0000 0001 2200 8888. GRID: grid.9841.4
FAU - Sardu, Celestino
AU  - Sardu C
AD  - Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, 
      Universita degli Studi della Campania "Luigi Vanvitelli", Caserta, Italy. ISNI: 
      0000 0001 2200 8888. GRID: grid.9841.4
FAU - Balestrieri, Maria Luisa
AU  - Balestrieri ML
AD  - Department of Biochemistry, Biophysics and General Pathology, Universita degli 
      Studi della Campania "Luigi Vanvitelli", Caserta, Italy. ISNI: 0000 0001 2200 
      8888. GRID: grid.9841.4
FAU - Siniscalchi, Mario
AU  - Siniscalchi M
AD  - Department of Cardiology, Hospital Cardarelli, Naples, Italy. GRID: grid.413172.2
FAU - Minicucci, Fabio
AU  - Minicucci F
AD  - Department of Cardiology, Hospital Cardarelli, Naples, Italy. GRID: grid.413172.2
FAU - Signoriello, Giuseppe
AU  - Signoriello G
AD  - Department of Mental Health and Public Medicine, Section of Statistic, Universita 
      degli Studi della Campania "Luigi Vanvitelli", Caserta, Italy. ISNI: 0000 0001 
      2200 8888. GRID: grid.9841.4
FAU - Calabro, Paolo
AU  - Calabro P
AD  - Department of Cardio-Thoracic and Respiratory Sciences, Universita degli Studi 
      della Campania "Luigi Vanvitelli", Caserta, Italy. ISNI: 0000 0001 2200 8888. 
      GRID: grid.9841.4
FAU - Mauro, Ciro
AU  - Mauro C
AD  - Department of Cardiology, Hospital Cardarelli, Naples, Italy. GRID: grid.413172.2
FAU - Pieretti, Gorizio
AU  - Pieretti G
AD  - Multidisciplinary Department of Surgical and Dental Specialties, Universita degli 
      Studi della Campania "Luigi Vanvitelli", Caserta, Italy. ISNI: 0000 0001 2200 
      8888. GRID: grid.9841.4
FAU - Coppola, Antonino
AU  - Coppola A
AD  - Cardiovascular Department, Hospital of Misericordia, Sorrento, Italy.
FAU - Nicoletti, Gianfranco
AU  - Nicoletti G
AD  - Multidisciplinary Department of Surgical and Dental Specialties, Universita degli 
      Studi della Campania "Luigi Vanvitelli", Caserta, Italy. ISNI: 0000 0001 2200 
      8888. GRID: grid.9841.4
FAU - Rizzo, Maria Rosaria
AU  - Rizzo MR
AD  - Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, 
      Universita degli Studi della Campania "Luigi Vanvitelli", Caserta, Italy. ISNI: 
      0000 0001 2200 8888. GRID: grid.9841.4
FAU - Paolisso, Giuseppe
AU  - Paolisso G
AD  - Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, 
      Universita degli Studi della Campania "Luigi Vanvitelli", Caserta, Italy. ISNI: 
      0000 0001 2200 8888. GRID: grid.9841.4
FAU - Barbieri, Michelangela
AU  - Barbieri M
AD  - Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, 
      Universita degli Studi della Campania "Luigi Vanvitelli", Caserta, Italy. ISNI: 
      0000 0001 2200 8888. GRID: grid.9841.4
LA  - eng
PT  - Journal Article
DEP - 20180103
PL  - England
TA  - Diabetol Metab Syndr
JT  - Diabetology & metabolic syndrome
JID - 101488958
PMC - PMC5751832
OTO - NOTNLM
OT  - *Non-obstructive coronary stenosis
OT  - *STEMI
OT  - *Type 2 diabetes
EDAT- 2018/01/09 06:00
MHDA- 2018/01/09 06:01
PMCR- 2018/01/03
CRDT- 2018/01/09 06:00
PHST- 2017/10/28 00:00 [received]
PHST- 2017/12/20 00:00 [accepted]
PHST- 2018/01/09 06:00 [entrez]
PHST- 2018/01/09 06:00 [pubmed]
PHST- 2018/01/09 06:01 [medline]
PHST- 2018/01/03 00:00 [pmc-release]
AID - 304 [pii]
AID - 10.1186/s13098-017-0304-3 [doi]
PST - epublish
SO  - Diabetol Metab Syndr. 2018 Jan 3;10:1. doi: 10.1186/s13098-017-0304-3. 
      eCollection 2018.