PMID- 32805324
OWN - NLM
STAT- MEDLINE
DCOM- 20210527
LR  - 20210527
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 323
DP  - 2021 Jan 15
TI  - Cardiac mortality, diabetes mellitus, and multivessel disease in ST elevation 
      myocardial infarction.
PG  - 13-18
LID - S0167-5273(20)33548-8 [pii]
LID - 10.1016/j.ijcard.2020.08.021 [doi]
AB  - BACKGROUND: In patients with diabetes mellitus presenting with ST elevation 
      myocardial infarction (STEMI) the degree to which cardiac death rates may be 
      attributed to an increased burden of coronary artery disease is not clear. 
      METHODS: This prospective observational study examines rates of cardiac death 
      between those with and without diabetes at long term follow up, stratified by 
      presence of multivessel disease (MVD), in consecutive STEMI patients from 5 
      Australian hospitals. RESULTS: Amongst 2083 patients, 393 patients had diabetes 
      (18.8%), and 810 (38.8%) had MVD. Patients with diabetes were more likely to have 
      MVD 48.6% (191/393) than patients without diabetes 36.6% (619/1690; p < .001). At 
      final follow up (median 3.6 years [IQR 2.4-5.4]) cardiac death occurred in 37/393 
      diabetic patients and 92/1690 nondiabetic patients (adjusted HR1.67, 95% CI 
      1.10-2.52). In those with MVD cardiac death occurred in 27/191 diabetic patients, 
      and 54/619 non-diabetic patients (adjusted HR 1.94; 95% CI 1.17-3.23). In single 
      vessel disease (SVD) cardiac death occurred in 10/202 diabetic patients, and 
      38/1071 non-diabetic patients (adjusted HR 1.37; 95% CI 0.65-2.89). Both diabetes 
      and MVD were independently associated with cardiac death. CONCLUSIONS: STEMI 
      patients with diabetes are more likely to have MVD, with an absolute difference 
      in MVD rates of 12%, and higher rates of cardiac death. Randomized trials 
      studying these high risk patients are needed to reduce cardiac mortality in 
      patients with diabetes, MVD and STEMI.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Burgess, Sonya
AU  - Burgess S
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia; 
      The University of New South Wales, Sydney, Australia; Cardiology Department, 
      Nepean Hospital, Sydney, Australia. Electronic address: 
      Sonya.Burgess@health.nsw.gov.au.
FAU - Juergens, Craig P
AU  - Juergens CP
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia; 
      The University of New South Wales, Sydney, Australia.
FAU - Yang, Wesley
AU  - Yang W
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia.
FAU - Shugman, Ibrahim M
AU  - Shugman IM
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia.
FAU - Idris, Hanan
AU  - Idris H
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia.
FAU - Nguyen, Tuan
AU  - Nguyen T
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia; 
      The University of New South Wales, Sydney, Australia.
FAU - McLean, Alison
AU  - McLean A
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia.
FAU - Leung, Melissa
AU  - Leung M
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia; 
      The University of New South Wales, Sydney, Australia.
FAU - Thomas, Liza
AU  - Thomas L
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia; 
      The University of New South Wales, Sydney, Australia; Cardiology Department, 
      Westmead Hospital, Sydney, Australia.
FAU - Robledo, Kristy P
AU  - Robledo KP
AD  - NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.
FAU - Mussap, Christian
AU  - Mussap C
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia; 
      The University of New South Wales, Sydney, Australia.
FAU - Lo, Sidney
AU  - Lo S
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia; 
      The University of New South Wales, Sydney, Australia.
FAU - French, John
AU  - French J
AD  - Cardiology Department, Ingham Institute at Liverpool Hospital, Sydney, Australia; 
      The University of New South Wales, Sydney, Australia; Western Sydney University, 
      Sydney, Australia.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20200814
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Australia/epidemiology
MH  - *Coronary Artery Disease/diagnostic imaging
MH  - *Diabetes Mellitus/diagnosis/epidemiology
MH  - Humans
MH  - *Percutaneous Coronary Intervention
MH  - Risk Factors
MH  - *ST Elevation Myocardial Infarction/diagnosis
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Acute coronary syndrome
OT  - Cardiac mortality
OT  - Diabetes mellitus
OT  - Incomplete revascularization
OT  - Prognosis
COIS- Declaration of Competing Interest No relevant relationships with industry, other 
      entities, or conflicts of interest exist.
EDAT- 2020/08/18 06:00
MHDA- 2021/05/28 06:00
CRDT- 2020/08/18 06:00
PHST- 2020/05/16 00:00 [received]
PHST- 2020/07/04 00:00 [revised]
PHST- 2020/08/07 00:00 [accepted]
PHST- 2020/08/18 06:00 [pubmed]
PHST- 2021/05/28 06:00 [medline]
PHST- 2020/08/18 06:00 [entrez]
AID - S0167-5273(20)33548-8 [pii]
AID - 10.1016/j.ijcard.2020.08.021 [doi]
PST - ppublish
SO  - Int J Cardiol. 2021 Jan 15;323:13-18. doi: 10.1016/j.ijcard.2020.08.021. Epub 
      2020 Aug 14.