Impact of diabetes mellitus on long term clinical outcome in patients with acute myocardial infarction undergoing percutaneous coronary intervention

Abstract

Background: Few data exist on the long-term clinical impact of diabetes mellitus (DM) in patients with acute myocardial infarction (AMI) undergoing successful percutaneous coronary intervention (PCI). Methods: We retrospectively analyzed a total of 4,754 acute myocardial infarction patients who successfully underwent PCI from January 2004 to December 2009 in COREA-AMI (COnvergent REgistry of cAtholic and chonnAm university for AMI) registry. We compared major adverse cardiac and cerebral events (MACCE) in AMI patients with diabetes mellitus with those without diabetes mellitus. Results: The median follow up period was 39 months (interquartile range 22.8 – 55.3 months). The cumulative rates of all-cause death, cardiac death, target lesion revasculariazion (TLR), and target vessel revascularization (TVR) were signficantly higher in the DM group. After adjusting with multivariable Cox regression analysis, DM group showed worse clinical outcomes than the non-DM group in terms of death (adjusted hazard ration (HR) 1.232, 95% confidence interval (CI) 1.072-1.415 and p=0.003) and a composite of MACCE (adjusted hazard ration (HR) 1.231, 95% confidence interval (CI) 1.101-1.376 and p<0.001). MACCE in patients with and without DM Conclusions: DM is an independent risk factor for higher long-term MACCE in patients with AMI.