The aim of this study was to evaluate the impact of diabetes mellitus (DM) and glucose levels on the results of treatment of patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary interventions (PCIs). Materials and methods. Data were collected from all patients (n=1280) with STEMI who were admitted to the coronary care unit and underwent PCIs from 2006 to 2015. 212 (16.6%) patients with DM were compared with 1068 (83.4%) patients without DM (non-DM group). To investigate the influence of the blood glucose levels, all patients were divided into two groups above and below the median of blood glycemia (7.52 mmol/l). Results. Thus, 634 patients with high level of blood glycemia (>7.52 mmol/l) were compared with 635 patients with low level of blood glycemia (≤7.52 mmol/l). In comparing of DM and non-DM groups there were no differences in the rate of death (5.2% vs 4.2%, р=0.526), stent thrombosis (1.4% vs 1.0%, р=0.622), recurrent myocardial infarction (MI) (1.4% vs 1.2%, р=0.813) and major adverse cardiac events (MACE) (7.5% vs 5.4%, р=0.228), which included in-hospital death, recurrent MI and stent thrombosis. The rates of angiographic success (92.9% vs 93.8%, р=0.625) and no-reflow (6.6% vs 5%, р=0.327) also were comparable between groups. The rates of death (6.3% vs 2.5%, р=0.001), MACEs (7.6% vs 4.1%, р=0.008), and no-reflow (6.9% vs 3.6%, р=0,009) were significantly higher in patients with high level of blood glycemia (>7.52 mmol/l). Angiographic success rate (95.1% vs 92.1%, р=0.029) was higher in patients with low level of glycemia (≤7.52 mmol/l). After multivariate adjustment, high level of blood glycemia (>7.52 mmol/l) remained an independent predictor of death (OR=2.28; 95% CI 1.18-4.40, р=0.014), MACE (OR=2.08; 95% CI 1.16-3.75, р=0.014) and no-reflow (OR=2.07; 95% CI 1.15-3.74, р=0.015). At the same time DM wasn’t associated with death, MACE or no-reflow. Conclusion. High level of blood glycemia was an independent predictor of death, MACE and no-reflow in patients with STEMI, undergoing PCI. The presence of DM was not associated with worse in-hospital outcomes.
Aimof this study was to evaluate the impact of direct stenting (DS) strategy on the results of treatment of female patients with STelevation myocardial infarction (STEMI) undergoing percutaneous coronary interventions (PCIs).Materials and methods. Among 1297 patients with STEMI admitted to the coronary care unit and subjected to PCIs from 2006 to 2015 there were 330 women (25.4 %). Data from 161 women (48.8 %) who underwent DS were compared with those from 169 women who underwent indirect stenting (IS). Among patients of IS group in 148 (87.6 %) stenting was performed after predilation, in 7 (4.1 %) after manual thrombus aspiration, and in 14 (8.3 %) after combination of predilation and thrombus aspiration.Results. The rate of angiographic success was higher in the DS group (97.5 vs. 87.6 %, р<0.001). Rates of deaths (4.3 vs. 11.8 %; p=0.013), major adverse cardiac events (MACE)(4.3 vs. 13 %; p=0.005), and no-reflow (1.9 % vs. 11.2 %; p=0.013) were significantly lower in the DS group. There were no differences in rates of recurrent myocardial infarction and access site complications. Following propensity score matching, each group contained 78 patients. Rates of MACE (2.6 vs. 14.1 %; p=0.009) and deaths (2.6 vs. 12.8 %; p=0.016) remained significantly lower in the DS group. After multivariate adjustment, DS strategy was independently associated with lower mortality (odds ratio [OR] 0.29; 95 % confidence interval [CI] 0.09–0.97; p=0.04) and MACE (OR=0.28; 95 %CI 0.09–0.087; p=0.03).Conclusion. DS strategy in STEMI female patients turned out to be safe and effective technique.
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