Abstract
Introduction: Primary PCI (pPCI) is the gold standard in the treatment of patients with acute myocardial infarction (AMI) with ST elevation (STEMI). Aim: The purpose of this study is to evaluate the influence of diabetic status upon arrival at five year survival in patients with STEMI that were treated with pPCI. Material and methods: Consecutive data for 2087 patients admitted in the period from 1st of January 2009. to 31st of December 2010. with diagnosis of acute STEMI were collected from catheterisation laboratory cardiology clinic CCS electronic database. Patients were divided into 3 groups: those without diabetes mellitus (DM), IDDM (insulin dependent diabetes mellitus), NIDDM (non-insulin dependent diabetes mellitus). Results: 1664 patients (79.7%) did not have DM, 98 (4.7%) had IDDM and 325 (15.6%) had NIDDM. There was a statistically significant difference in mortality rate among three groups after 30 days, one year and five years after intervention, and the highest rates were recorded at the IDDM patients, then at the NIDDM and the lowest in patients without DM (15.3% vs 8.3% vs 5.9 %, p < 0.001 after 30 days; 21.4% vs 15.4% vs 10.9%, p < 0.001 after one year and 32.7% vs 24.3% vs 18%, p < 0.001 after 5 years). Also, there was a highly statistically significant difference in five-year mortality rate between patients with and without DM (26.2 % vs 17.6%, p < 0.001). IDDM was a independent factor when it comes to predicting five-year mortality (HR = 1.58, 95% CI 1.07-2.32, p = 0.02) whereas NIDDM was not (HR = 1.24, 95% CI 0.95-1.63, p = 0.12). Conclusion: Diabetic patients had an increased risk of mortality in the short and long-term follow-up after pPCI. Insulin-dependent was a single predicting factor after five year follow-up.
Highlights
Primary Percutaneous coronary intervention (PCI) is the gold standard in the treatment of patients with acute myocardial infarction (AMI) with ST elevation (STEMI)
Aim: The purpose of this study is to evaluate the influence of diabetic status upon arrival at five year survival in patients with segment elevation myocardial infarction (STEMI) that were treated with Primary PCI (pPCI)
There was a statistically significant difference in mortality rate among three groups after 30 days, one year and five years after intervention, and the highest rates were recorded at the IDDM patients, at the NIDDM and the lowest in patients without diabetes mellitus (DM) (15.3% vs 8.3% vs 5.9 %, p < 0.001 after 30 days; 21.4% vs 15.4% vs 10.9%, p < 0.001 after one year and 32.7% vs 24.3% vs 18%, p < 0.001 after 5 years)
Summary
Primary PCI (pPCI) is the gold standard in the treatment of patients with acute myocardial infarction (AMI) with ST elevation (STEMI). Acute myocardial infarction (AMI) is the leading cause of morbidity and mortality in the world. Primary angioplasty of acute myocardial infarction, or primary PCI (pPCI) are the terms relating to the use of balloon angioplasty, usually with stent implantation, in opening blocked coronary arteries instead of thrombolytic therapy. It is the gold standard in the treatment of patients with acute myocardial infarction with ST segment elevation myocardial infarction (STEMI)
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