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药物洗脱支架成功治疗 ST 段抬高型心肌梗死伴多支血管病变的糖尿病前期和糖尿病患者的两年临床结局比较。

Two-Year Clinical Outcomes Between Prediabetic and Diabetic Patients With STEMI and Multivessel Disease Who Underwent Successful PCI Using Drug-Eluting Stents.

机构信息

Division of Cardiology, Department of Internal Medicine, 85082Kangwon National University School of Medicine, Chuncheon, Republic of Korea.

Department of Cardiology, 65416Chonnam National University Hospital, Gwangju, Republic of Korea.

出版信息

Angiology. 2021 Jan;72(1):50-61. doi: 10.1177/0003319720949311. Epub 2020 Aug 18.

Abstract

To evaluate clinical implication of prediabetes, we compared a 2-year major clinical outcome including patient-oriented composite outcomes (POCOs), stent thrombosis (ST), and stroke between prediabetes and diabetes in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD). A total of 4097 patients with STEMI and MVD (normoglycemia [group A: 1001], prediabetes [group B: 1518], and diabetes [group C: 1578]) who received drug-eluting stents were evaluated. Patient-oriented composite outcomes were defined as all-cause death, recurrent myocardial infarction (MI), or any repeat revascularization. The cumulative incidences of POCOs, ST, and stroke were similar between groups B and C. The cumulative incidences of all-cause death (adjusted hazard ratio [aHR]: 1.483; 95% CI: 1.027-2.143; = .036) and all-cause death or MI (aHR: 1.429, 95% CI: 1.034-1.974; = .031) were higher in group B than in group A. The cumulative incidences of all-cause death (aHR: 1.563; 95% CI: 1.089-2.243; = .015), cardiac death (aHR: 1.661; 95% CI: 1.123-2.457; = .011), and all-cause death or MI were higher in group C than in group A. In conclusion, prediabetes could potentially have a similar impact as diabetes on major clinical outcomes in patients with STEMI and MVD.

摘要

为了评估糖尿病前期的临床意义,我们比较了 ST 段抬高型心肌梗死(STEMI)和多血管疾病(MVD)患者中糖尿病前期和糖尿病患者 2 年主要临床结局(包括以患者为中心的复合结局(POCOs)、支架血栓形成(ST)和卒中)。共评估了 4097 例接受药物洗脱支架治疗的 STEMI 和 MVD 患者(血糖正常[组 A:1001 例]、糖尿病前期[组 B:1518 例]和糖尿病[组 C:1578 例])。以患者为中心的复合结局定义为全因死亡、复发性心肌梗死(MI)或任何重复血运重建。组 B 和组 C 的 POCOs、ST 和卒中的累积发生率相似。组 B 的全因死亡(校正风险比[aHR]:1.483;95%CI:1.027-2.143; =.036)和全因死亡或 MI(aHR:1.429,95%CI:1.034-1.974; =.031)的累积发生率高于组 A。组 B 的全因死亡(aHR:1.563;95%CI:1.089-2.243; =.015)、心脏性死亡(aHR:1.661;95%CI:1.123-2.457; =.011)和全因死亡或 MI 的累积发生率高于组 A。总之,糖尿病前期可能与糖尿病对 STEMI 和 MVD 患者的主要临床结局有相似的影响。

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