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Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization: Analysis of the prospective registry of DIAMOND (DIabetic acute myocardial infarctiON Disease) in Korea: an observational registry study

Authors
 Seung-Ho Hur  ;  Ki-Bum Won  ;  In-Cheol Kim  ;  Jang-Ho Bae  ;  Dong-Ju Choi  ;  Young-Keun Ahn  ;  Jong-Seon Park  ;  Hyo-Soo Kim  ;  Rak-Kyeong Choi  ;  Donghoon Choi  ;  Joon-Hong Kim  ;  Kyoo-Rok Han  ;  Hun-Sik Park  ;  So-Yeon Choi  ;  Jung-Han Yoon  ;  Hyeon-Cheol Gwon  ;  Seung-Woon Rha  ;  Wooyeong Jang  ;  Jang-Whan Bae  ;  Kyung-Kuk Hwang  ;  Do-Sun Lim  ;  Kyung-Tae Jung  ;  Seok-Kyu Oh  ;  Jae-Hwan Lee  ;  Eun-Seok Shin  ;  Kee-Sik Kim 
Citation
 MEDICINE, Vol.95(25) : 3882, 2016 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2016
MeSH
Cause of Death/trends ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/etiology* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Myocardial Infarction/complications* ; Myocardial Infarction/mortality ; Myocardial Infarction/surgery ; Percutaneous Coronary Intervention* ; Prognosis ; Propensity Score ; Prospective Studies ; Registries* ; Republic of Korea/epidemiology ; Risk Assessment/methods* ; Risk Factors ; Survival Rate/trends ; Treatment Outcome
Keywords
acute myocardial infarction ; diabetes mellitus ; major adverse cardiac events
Abstract
This study assessed the 2-year clinical outcomes of patients with diabetes mellitus (DM) after acute myocardial infarction (AMI) in a cohort of the DIAMOND (DIabetic Acute Myocardial infarctiON Disease) registry. Clinical outcomes were compared between 1088 diabetic AMI patients in the DIAMOND registry after stabilization of MI and 1088 nondiabetic AMI patients from the KORMI (Korean AMI) registry after 1?:?1 propensity score matching using traditional cardiovascular risk factors. Stabilized patients were defined as patients who did not have any clinical events within 1 month after AMI. Primary outcomes were the 2-year rate of major adverse cardiac events (MACEs), a composite of all-cause death, recurrent MI (re-MI), and target vessel revascularization (TVR). Matched comparisons revealed that diabetic patients exhibited significantly lower left ventricular ejection fraction (LVEF) and estimated glomerular filtration rate and smaller stent size. Diabetic patients exhibited significantly higher 2-year rates of MACE (8.0% vs 3.7%), all-cause death (3.9% vs 1.4%), re-MI (2.8% vs 1.2%), and TVR (3.5% vs 1.3%) than nondiabetic patients (all P?<?0.01), and higher cumulative rates in Kaplan-Meier analyses of MACE, all-cause death, and TVR (all P?<?0.05). A multivariate Cox regression analysis revealed that chronic kidney disease, LVEF?<?35%, and long stent were independent predictors of MACE, and large stent diameter and the use of drug-eluting stents were protective factors against MACE. The 2-year MACE rate beyond 1 month after AMI was significantly higher in DM patients than non-DM patients, and this rate was associated with higher comorbidities, coronary lesions, and procedural characteristics in DM.
Files in This Item:
T201603108.pdf Download
DOI
10.1097/MD.0000000000003882
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, In Cheol(김인철)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151904
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