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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.

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Affiliated Author(s)
허승호
Alternative Author(s)
Hur, Seung Ho
Journal Title
Medicine
ISSN
1357-3039
Issued Date
2016
Keyword
Acute myocardial infarctionDiabetes mellitusMajor 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 wassignificantly higher in DM patients than non-DM patients, and this rate was associated with higher comorbidities, coronary lesions,
and procedural characteristics in DM.
Abbreviations: ACE-I = angiotensin-converting enzyme inhibitor, AMI = acute myocardial infarction, ARBs = angiotensin receptor
blockers, BMI = body mass index, BP = blood pressure, CAD = coronary artery disease, CKD = chronic kidney disease, CK-MB =
creatine kinase-myocardial band fraction, CV = cardiovascular, DM = diabetes mellitus, DPP4-I = dipeptidyl peptidase 4 inhibitors,
eGFR = estimated glomerular filtration rate, GP = glycoprotein, hs-CRP = high-sensitivity C-reactive protein, LAD = left anterior
descending artery, LCX = left circumflex artery, LM = left main coronary artery, LVEF = left ventricular ejection fraction, MACE = major
adverse cardiac events, PCI = percutaneous coronary intervention, QCA = quantitative coronary angiography, RCA = right coronary
artery, reMI = recurrent myocardial infarction, ST = stent thrombosis, STEMI = ST-elevation myocardial infarction, TIMI =
thrombolysis in myocardial infarction, TVR = target vessel revascularization.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
Seung-Ho Hur et al. (2016). 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. Medicine, 95(25), e3882–e3882. doi: 10.1097/MD.0000000000003882
Type
Article
ISSN
1357-3039
DOI
10.1097/MD.0000000000003882
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33161
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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