Outcomes in prediabetes vs. diabetes in patients with non-ST-segment elevation myocardial infarction undergoing percutaneous intervention.

Abstract

OBJECTIVE:

The comparative long-term clinical outcomes between patients with prediabetes and diabetes in patients with non-ST-elevation myocardial infarction (NSTEMI) and multivessel disease (MVD) who were undergoing percutaneous coronary intervention (PCI) are not well known. We therefore compared the 2-year clinical outcomes in such patients.

METHODS:

A total of 2963 patients with NSTEMI and MVD [normoglycemia (group A, n = 629), prediabetes (group B, n = 802), and diabetes (group C, n = 1532)] were evaluated. The primary outcomes were the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization. The secondary outcome was stent thrombosis.

RESULTS:

The cumulative incidence of MACE as well as for death or MI in group B and C were similar when compared to each other. However, they (P = 0.048 and P = 0.017, respectively and P = 0.022 and P = 0.001, respectively) were significantly higher than in group A. The cumulative incidence of all-cause death in group B (P = 0.042) and all-cause death and cardiac death in group C (P = 0.001 and P = 0.028, respectively) were significantly higher than in group A. However, those of all-cause death, cardiac death, Re-MI, any repeat revascularization, and ST were not significantly different between groups B and C.

CONCLUSION:

In this study, patients with NSTEMI and MVD who underwent successful implantation of newer-generation DES and were prediabetic had worse outcomes compared to normoglycemics and comparable to those with diabetes.

• Authors: Yong Hoon Kim, Ae-Young Her, Myung Ho Jeong, Byeong-Keuk Kim, Sung-Jin Hong, Seunghwan Kim, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
• Journal: Coronary artery disease (Coron Artery Dis) Vol. 32 Issue 3 Pg. 211-223 (May 01 2021) ISSN: 1473-5830 [Electronic] England
• PMID: 33060525 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Observational Study)
• Copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Topics

• Aged
• Diabetes Mellitus
• Female
• Humans
• Male
• Middle Aged
• Non-ST Elevated Myocardial Infarction (surgery)
• Percutaneous Coronary Intervention
• Prediabetic State
• Recurrence
• Republic of Korea
• Retrospective Studies
• Stents