Prognostic impact of diabetes mellitus and hypertension for mid-term outcome of patients with acute myocardial infarction who underwent percutaneous coronary intervention

Abstract

BackgroundThe synergistic effect of diabetes mellitus (DM) and hypertension on mid-term outcome among acute myocardial infarction (MI) patients undergoing percutaneous coronary intervention (PCI) is still controversial. MethodsA total of 2438 patients with acute MI who underwent PCI from January 2007 to November 2010 were studied. Patients were stratified to four groups according to the presence of DM or hypertension and followed up during 12 months. We analyzed the influence of hypertension and DM on major adverse cardiac events (MACE: death, recurrent MI, repeated coronary artery revascularization). ResultsNo history of hypertension or DM was found in 35.0%, a history of hypertension in 27.2%, a history of DM in 15.0%, and a history of both disease entities in 22.8%. The rate of MACE was significantly higher in hypertensive DM group (15.9% vs. 22.9% vs. 28.8% vs. 37.0%, log-rank p<0.001). In multivariate analysis, hypertension and DM were meaningful predictors of mid-term mortality, and the combination of the two was a stronger predictor (hazard ratio=1.790; 95% confidence interval=1.313–2.442; p<0.001). ConclusionsAfter PCI, acute MI patients with a history of DM or hypertension had a higher mid-term mortality than acute MI patients without such a history. The combination of DM and hypertension appeared to be more strongly associated with mortality than DM or hypertension alone.