Tunis Med. 2022;100(2):143-148.
Diabetes Mellitus (DM) is known to be associated with worse outcomes following percutaneous coronary intervention (PCI).
To assess prognostic impact of DM on patients managed by urgent PCI following ST-segment elevation myocardial infarction (STEMI).
In a retrospective study, STEMI patients admitted to our department from January 2016 to December 2019 and treated with urgent PCI (primary or rescue PCI) were included. They were divided in two groups: Diabetic and non-diabetic patients. They were followed-up for a period of 12 months. Major cardiac adverse event (MACE) was a composite outcome of the following events: myocardial infarction, target vessel revascularization, target lesion revascularization or cardiovascular death. MACEs were collected during follow-up.
Our population consisted of 225 patients. DM was observed in 104 STEMI patients (46.2%). Diabetic patients had higher frequency of hypertension (p 1.4mmol/l (p 75 years, hyperglycemia at admission (>10mmol/l), extensive anterior infarction and procedure failure were associated with in-hospital mortality in the non-diabetic group. Factors associated with 12-months mortality and MACEs among diabetic patients were age > 75 years, anemia, CKD and left ventricular systolic dysfunction.
Despite modern era of STEMI treatment, diabetic patients still have a poor prognosis. These results highlight the need for coronary risk factors treatment among these patients.
已知糖尿病（DM）与经皮冠状动脉介入治疗（PCI）后的不良结局有关。
评估糖尿病对急性 ST 段抬高型心肌梗死（STEMI）患者行紧急 PCI 后的预后影响。
在一项回顾性研究中，纳入了 2016 年 1 月至 2019 年 12 月期间我院收治并接受紧急 PCI（直接 PCI 或补救性 PCI）治疗的 STEMI 患者。根据是否患有糖尿病将患者分为两组：糖尿病患者和非糖尿病患者。对患者进行了为期 12 个月的随访。主要心脏不良事件（MACE）是以下事件的复合结局：心肌梗死、靶血管血运重建、靶病变血运重建或心血管死亡。在随访期间收集 MACE 事件。
我们的研究人群共包括 225 例患者。其中 104 例（46.2%）STEMI 患者患有糖尿病。与非糖尿病患者相比，糖尿病患者高血压的发生率更高（p<0.001），入院时高血糖（>10mmol/L）、广泛前壁梗死和手术失败与非糖尿病患者的院内死亡率相关。与糖尿病患者 12 个月死亡率和 MACE 相关的因素包括年龄>75 岁、贫血、CKD 和左心室收缩功能障碍。
尽管目前 STEMI 治疗已经取得了很大进展，但糖尿病患者的预后仍然较差。这些结果强调了需要对这些患者进行冠状动脉危险因素治疗。
