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 and Jiří JARKOVSKÝ. The Effect of Diabetes on Prognosis Following Myocardial Infarction Treated with Primary Angioplasty and Potent Antiplatelet Therapy. Journal of Clinical Medicine. BASEL: MDPI, 2020, vol. 9, No 8, p. 1-11. ISSN 2077-0383. Available from: https://dx.doi.org/10.3390/jcm9082555.
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Basic information
Original name The Effect of Diabetes on Prognosis Following Myocardial Infarction Treated with Primary Angioplasty and Potent Antiplatelet Therapy
Authors SIMEK, Stanislav (203 Czech Republic), Zuzana MOŤOVSKÁ (703 Slovakia, guarantor), Ota HLINOMAZ (203 Czech Republic, belonging to the institution), Petr KALA (203 Czech Republic, belonging to the institution), Milan HROMADKA (203 Czech Republic), Jiri KNOT (203 Czech Republic), Ivo VARVAROVSKY (203 Czech Republic), Jaroslav DUSEK (203 Czech Republic), Richard ROKYTA (203 Czech Republic), Frantisek TOUSEK (203 Czech Republic), Michal SVOBODA (203 Czech Republic, belonging to the institution), Alexandra VODZINSKA (203 Czech Republic), Jan MROZEK (203 Czech Republic) and Jiří JARKOVSKÝ (203 Czech Republic).
Edition Journal of Clinical Medicine, BASEL, MDPI, 2020, 2077-0383.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30218 General and internal medicine
Country of publisher Switzerland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 4.241
RIV identification code RIV/00216224:14110/20:00116476
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.3390/jcm9082555
UT WoS 000567080400001
Keywords in English acute myocardial infarction; primary percutaneous coronary intervention; diabetes mellitus; prognosis; antiplatelets; prasugrel; ticagrelor; clopidogrel
Tags 14110115, 14110211, 14119612, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Michal Petr, učo 65024. Changed: 21/9/2023 10:58.
Abstract
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.
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