Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
Korean J Intern Med. 2021 Mar;36(Suppl 1):S99-S113. doi: 10.3904/kjim.2020.477. Epub 2021 Jan 12.
BACKGROUND/AIMS: This study compared long-term clinical outcomes between male and female acute myocardial infarction (AMI) patients with and without diabetes mellitus (DM).
From November 2011 to December 2015, 13,104 patients with AMI were enrolled in the Korea Acute Myocardial Infarction Registry National Institutes of Health (KAMIR-NIH) (4,458 diabetic patients and 8,646 non-diabetic patients). Propensity score matching (PSM) was used to reduce bias due to confounding variables. Following PSM, 2,046 diabetic patients, 1,023 males (69.8 ± 9.4 years) and 1,023 females (69.9 ± 9.4 years); and 3,412 non-diabetic patients, 1,706 males (70.0 ± 10.4 years) and 1,706 females (70.4 ± 10.8 years) were analyzed. Clinical outcomes were compared between male and female patients with and without diabetes over a 3-year clinical follow-up.
In diabetic patients, mortality (21.1% vs. 21.5%, p = 0.813) and major adverse cardiac events (MACE) (30.6% vs. 31.4%, p = 0.698) were not significantly different between males and females. However, mortality (15.8% vs. 12.0%, p = 0.002) and MACE (20.8% vs. 15.6%, p < 0.001) were significantly higher in male non-diabetic patients than in female non-diabetic patients. The predictors of mortality for both males and females in the diabetic and non-diabetic groups were old age, heart failure, renal dysfunction, anemia, and no percutaneous coronary intervention.
The long-term clinical outcomes in AMI patients with DM did not significantly differ by sex. However, the mortality and MACE in non-diabetic male patients were higher than those in females.
背景/目的：本研究比较了伴有和不伴有糖尿病的男性和女性急性心肌梗死（AMI）患者的长期临床结局。
2011 年 11 月至 2015 年 12 月，共有 13104 例 AMI 患者纳入韩国急性心肌梗死注册国立卫生研究院（KAMIR-NIH）（4458 例糖尿病患者和 8646 例非糖尿病患者）。采用倾向评分匹配（PSM）来减少因混杂变量导致的偏倚。经过 PSM 后，共分析了 2046 例糖尿病患者，其中 1023 例男性（69.8±9.4 岁）和 1023 例女性（69.9±9.4 岁）；3412 例非糖尿病患者，1706 例男性（70.0±10.4 岁）和 1706 例女性（70.4±10.8 岁）。在 3 年临床随访期间，比较了男性和女性患者伴或不伴糖尿病的临床结局。
在糖尿病患者中，男性和女性之间的死亡率（21.1% vs. 21.5%，p=0.813）和主要不良心脏事件（MACE）（30.6% vs. 31.4%，p=0.698）并无显著差异。然而，男性非糖尿病患者的死亡率（15.8% vs. 12.0%，p=0.002）和 MACE（20.8% vs. 15.6%，p<0.001）显著高于女性非糖尿病患者。在糖尿病和非糖尿病组中，男性和女性患者的死亡预测因素均为高龄、心力衰竭、肾功能不全、贫血和未行经皮冠状动脉介入治疗。
伴有糖尿病的 AMI 患者的长期临床结局与性别无关。然而，非糖尿病男性患者的死亡率和 MACE 高于女性。
