Journal of the Hong Kong College of Cardiology

Volume 9 Number 4, October 2001
Abstract

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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