Journal of
the Hong Kong College of Cardiology
Volume 9 Number 4, October
2001
The Early and Late Clinical Outcomes of Diabetic Patients with Acute Myocardial
Infarction Treated by Primary Percutaneous Transluminal Coronary Angioplasty
Mingzhong Zhao, Dayi Hu, Tianchang Li, Sanqing Jia, Ming Yang,
Yuyun Xu
From Department of Cardiology, People's Hospital, Beijing University,
Beijing, China
ZHAO et al.: The Early and Late Clinical Outcomes of Diabetic Patients
with Acute Myocardial Infarction Treated by Primary Percutaneous Transluminal
Coronary Angioplasty. We study 339 patients with acute myocardial infarction
(AMI) consecutively treated by primary angioplasty (P-PTCA) patients were divided
into diabetes group (63 cases) and non-diabetes group (276 cases). The baseline
clinical characteristics, coronary angiogram and major cardiovascular events
(MACE) were analysed. No significant differences were observed in coronary artery
lesions between the 2 groups. During early follow-up (within 1 month), in diabetes
group, left ventricular ejection fraction (LVEF) was lower (0.54±0.10
vs 0.60±0.13, P<0.05), and incidence of non-fatal heart
failure was higher (16.7% vs 7.1%, P<0.05) than in non-diabetes group, but
cardiac death rate was similar (P>0.05). At late follow-up (mean 20.6±8.7
months), in diabetes group, the incidence of non-fatal heart failure and rate
of target vessel revascularization increased (P<0.05, P<0.01, respectively),
meanwhile incidence of MACE was higher (63.0% vs 32.7%, P<0.01) and survival
rate freedom from MACE decreased (37.0% vs 67.3%, P<0.01) compared with those
in non-diabetes group, but total cardiac mortality rates were similar in the
2 groups (7.4% vs 3.9%, P>0.05). Multivariate analysis indicated the presence
of diabetes (RR 4.15, 95% CI:1.29-15.62) and the LVEF were associated with a
higher incidence of MACE and they were independent risk factors respectively
affecting MACE free survival. MACE free survival rate is lower in AMI patients
with than not with diabetes treated by P-PTCA, but overall cardiac mortality
rates are similar in the 2 groups, which suggest P-PTCA be more likely to improve
the clinical benefit in terms of mortality rate, particularly in diabetes. (J
HK Coll Cardiol 2001;9:166-170)
Key words : Acute myocardial infarction, angioplasty, diabetes mellitus,
transluminal, percutaneous coronary, prognosis
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