Impact of Diabetes on Long-Term Outcome After Primary Angioplasty

• DOI: 10.2337/dc12-1507
• Publication Date: 2012-12-29T07:19:30Z
• Authors: Giuseppe De Luca; Maurits T. Dirksen; Christian Spaulding; Henning Kelbæk; Martin Schalij; Leif Thuesen; Bas van der Hoeven; Marteen A. Vink; Christoph Kaiser; Carmine Musto; Tania Chechi; Gaia Spaziani; Luis Salvador Dia...; Vincenzo Pasceri; Emilio Di Lorenzo; Roberto Violini; Harry Suryapranata; Gregg W. Stone
• Keywords: Male; Myocardial Infarction; 610; Middle Aged; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; ACUTE MYOCARDIAL-INFARCTION, PERCUTANEOUS CORONARY INTERVENTION, META-REGRESSION ANALYSIS, DRUG-ELUTING STENTS, IIB-IIIA INHIBITORS, BALLOON ANGIOPLASTY, RISK PROFILE, MELLITUS, GLUCOSE, HYPERGLYCEMIA; Diabetes Mellitus; Humans; Female; NCEBP 14: Cardiovascular diseases; Angioplasty, Balloon, Coronary; Original Research; Aged; Randomized Controlled Trials as Topic

Diabetes has been shown to be associated with worse survival and repeat target vessel revascularization (TVR) after primary angioplasty. The aim of the current study was evaluate impact diabetes on long-term outcome in patients undergoing angioplasty treated bare metal stents (BMS) drug-eluting (DES).Our population is represented by 6,298 ST-segment elevation myocardial infarction (STEMI) included DESERT database from 11 randomized trials comparing DES BMS.Diabetes observed 972 (15.4%) who were older (P < 0.001), more likely female higher prevalence hypertension hypercholesterolemia longer ischemia time without any difference angiographic procedural characteristics. At follow-up (1,201 ± 441 days), rates death (19.1% vs. 7.4%; P 0.0001), reinfarction (10.4% 7.5%; stent thrombosis (7.6% 4.8%; = 0.002) similar temporal distribution--acute, subacute, late, very late--between diabetic control patients, TVR (18.6% 15.1%; 0.006). These results confirmed receiving BMS or DES, except for TVR, there being no between nondiabetic DES. correction baseline confounding factors (mortality, 0.001; infarction, 0.006; thrombosis, 0.007; 0.027).This shows that among STEMI angioplasty, mortality, reinfarction, BMS. implantation, however, does mitigate known deleterious effect