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@article{1680300,
author = {Simek, Stanislav and Moťovská, Zuzana and Hlinomaz, Ota and Kala, Petr and Hromadka, Milan and Knot, Jiri and Varvarovsky, Ivo and Dusek, Jaroslav and Rokyta, Richard and Tousek, Frantisek and Svoboda, Michal and Vodzinska, Alexandra and Mrozek, Jan and Jarkovský, Jiří},
article_location = {BASEL},
article_number = {8},
doi = {http://dx.doi.org/10.3390/jcm9082555},
keywords = {acute myocardial infarction; primary percutaneous coronary intervention; diabetes mellitus; prognosis; antiplatelets; prasugrel; ticagrelor; clopidogrel},
language = {eng},
issn = {2077-0383},
journal = {Journal of Clinical Medicine},
title = {The Effect of Diabetes on Prognosis Following Myocardial Infarction Treated with Primary Angioplasty and Potent Antiplatelet Therapy},
url = {https://www.mdpi.com/2077-0383/9/8/2555},
volume = {9},
year = {2020}
}
TY - JOUR
ID - 1680300
AU - Simek, Stanislav - Moťovská, Zuzana - Hlinomaz, Ota - Kala, Petr - Hromadka, Milan - Knot, Jiri - Varvarovsky, Ivo - Dusek, Jaroslav - Rokyta, Richard - Tousek, Frantisek - Svoboda, Michal - Vodzinska, Alexandra - Mrozek, Jan - Jarkovský, Jiří
PY - 2020
TI - The Effect of Diabetes on Prognosis Following Myocardial Infarction Treated with Primary Angioplasty and Potent Antiplatelet Therapy
JF - Journal of Clinical Medicine
VL - 9
IS - 8
SP - 1-11
EP - 1-11
PB - MDPI
SN - 20770383
KW - acute myocardial infarction
KW - primary percutaneous coronary intervention
KW - diabetes mellitus
KW - prognosis
KW - antiplatelets
KW - prasugrel
KW - ticagrelor
KW - clopidogrel
UR - https://www.mdpi.com/2077-0383/9/8/2555
L2 - https://www.mdpi.com/2077-0383/9/8/2555
N2 - Purpose: To investigate the prognostic significance of diabetes mellitus (DM) in patients with high risk acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (pPCI) in the era of potent antithrombotics. Methods: Data from 1230 ST-segment elevation myocardial infarction (STEMI) patients enrolled in the PRAGUE-18 (prasugrel vs. ticagrelor in pPCI) study were analyzed. Ischemic and bleeding event rates were calculated for patients with and without diabetes. The independent impact of diabetes on outcomes was evaluated after adjustment for outcome predictors. Results: The prevalence of DMwas 20% (N = 250). Diabetics were older and more often female. They were more likely to have hypertension, hyperlipoproteinemia, multivessel coronary disease and left main disease, and be obese. The primary net-clinical endpoint (EP) containing death, spontaneous nonfatal MI, stroke, severe bleeding, and revascularization at day 7 occurred in 6.1% of patients with, and in 3.5% of patients without DM (HR 1.8; 95% CI 0.978-3.315; p = 0.055). At one year, the key secondary endpoint defined as cardiovascular death, spontaneous MI, or stroke occurred in 8.8% with, and 5.5% withoutDM(HR 1.621; 95% CI 0.987-2.661; p = 0.054). In those with DM the risk of total one-year mortality (6.8% vs. 3.9% (HR 1.773; 95% CI 1.001-3.141; p = 0.047)) and the risk of nonfatal reinfarction (4.8% vs. 2.2% (HR 2.177; 95% CI 1.077-4.398; p = 0.026)) were significantly higher compared to in those without DM. There was no risk of major bleeding associated with DM (HR 0.861; 95% CI 0.554-1.339; p = 0.506). In the multivariate analysis, diabetes was independently associated with the one-year risk of reinfarction (HR 2.176; 95% Confidence Interval, 1.055-4.489; p = 0.035). Conclusion: Despite best practices STEMI treatment, diabetes is still associated with significantly worse prognoses, which highlights the importance of further improvements in the management of this high-risk population.
ER -
SIMEK, Stanislav, Zuzana MOŤOVSKÁ, Ota HLINOMAZ, Petr KALA, Milan HROMADKA, Jiri KNOT, Ivo VARVAROVSKY, Jaroslav DUSEK, Richard ROKYTA, Frantisek TOUSEK, Michal SVOBODA, Alexandra VODZINSKA, Jan MROZEK a Jiří JARKOVSKÝ. The Effect of Diabetes on Prognosis Following Myocardial Infarction Treated with Primary Angioplasty and Potent Antiplatelet Therapy. \textit{Journal of Clinical Medicine}. BASEL: MDPI, 2020, roč.~9, č.~8, s.~1-11. ISSN~2077-0383. Dostupné z: https://dx.doi.org/10.3390/jcm9082555.
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