Impact of Diabetes Mellitus on Clinical Characteristics, Management, and In-hospital Outcomes in Patients With Acute Myocardial Infarction (from the NCDR)

Rousan, Talla A.; Pappy, Reji; Chen, Anita Y.; Roe, Matthew T.; Saucedo, Jorge

doi:10.1016/j.amjcard.2014.07.031

Cited by 44 publications

(38 citation statements)

References 30 publications

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“…However, the characteristics of our population (eg, age, sex, left anterior descending as the infarct-related artery, diabetes mellitus, reperfusion delay) do not differ from those of other studies. 11,28 We reported differences in the baseline characteristics between groups, but after adjustment, the primary end point results did not change. TIMI 3 flow restoration after thrombus aspiration was an inclusion criterion; however, after centralized assessment of angiograms, 8 patients (4 in each group) were reported with TIMI 2 flow in the infarct-related artery at randomization and were, per the modified intent-to-treat principle, included in the analysis; however, the results did not change in a perprotocol analysis.…”

Section: Limitationsmentioning

confidence: 99%

Comparison of Immediate With Delayed Stenting Using the Minimalist Immediate Mechanical Intervention Approach in Acute ST-Segment–Elevation Myocardial Infarction

Belle

Motreff

Mangin

et al. 2016

Circ: Cardiovascular Interventions

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Background-Delayed stent implantation after restoration of normal epicardial flow by a minimalist immediate mechanical intervention aims to decrease the rate of distal embolization and impaired myocardial reperfusion after percutaneous coronary intervention. We sought to confirm whether a delayed stenting (DS) approach (24-48 hours) improves myocardial reperfusion, versus immediate stenting, in patients with acute ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Methods and Results-In the prospective, randomized, open-label minimalist immediate mechanical intervention (MIMI)trial, patients (n=140) with ST-segment-elevation myocardial infarction ≤12 hours were randomized to immediate stenting (n=73) or DS (n=67) after Thrombolysis In Myocardial Infarction 3 flow restoration by thrombus aspiration. Patients in the DS group underwent a second coronary arteriography for stent implantation a median of 36 hours (interquartile range 29-46) after randomization. The primary end point was microvascular obstruction (% left ventricular mass) on cardiac magnetic resonance imaging performed 5 days (interquartile range 4-6) after the first procedure. There was a nonsignificant trend toward lower microvascular obstruction in the immediate stenting group compared with DS group (1.88% versus 3.96%; P=0.051), which became significant after adjustment for the area at risk (P=0.049). Median infarct weight, left ventricular ejection fraction, and infarct size did not differ between groups. No difference in 6-month outcomes was apparent for the rate of major cardiovascular and cerebral events. Conclusions-The

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Section: Limitationsmentioning

confidence: 99%

Comparison of Immediate With Delayed Stenting Using the Minimalist Immediate Mechanical Intervention Approach in Acute ST-Segment–Elevation Myocardial Infarction

Belle

Motreff

Mangin

et al. 2016

Circ: Cardiovascular Interventions

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“…After scanning the titles, abstracts, reading full texts and hand searching the reference lists of candidate articles, we finally got 19 prospective studies including a total of 35,994 STEMI patients to evaluate the associations between HbA 1c level and their in-hospital, 30-day and long-term mortality. Among these studies, there were 13 studies from Asia [3,8,10,12,13,[23][24][25][26][27][28][29][30], 5 from Europe [11,[31][32][33][34] and 1 from North America [35]. Detailed information of the eligible studies was shown in Table 1.…”

Section: Eligible Studiesmentioning

confidence: 99%

Prognostic value of glycated hemoglobin among patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis

Hou

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:Many studies have shown the prognostic significance of glycated hemoglobin (HbA 1c ) for overall coronary artery disease (CAD). But less is known about the role that HbA 1c played in the prognosis of patients diagnosed with ST-segment elevation myocardial infarction (STEMI).Results from previous studies were controversial. Therefore, a meta-analysis was conducted to investigate whether admission HbA 1c level was a predictor of short-and longterm mortality rates among patients diagnosed with STEMI. Relevant literatures were retrieved from the electronic databases up to March 2016. Reference lists were hand searched to identify eligible studies. Articles were included if they provided sufficient information for the calculation of pooled relative risk (RR) and its corresponding 95% confidence interval (CI). Finally, we got 19 prospective studies involving a total of 35,994 STEMI patients to evaluate the associations between HbA 1c level and their in-hospital, 30-day and long-term mortality. Among STEMI patients, HbA 1c level was not significantly associated with in-hospital mortality (RR 1.20, 95% CI 0.95-1.53, p = 0.13). However, elevated HbA 1c level was positively associated with risk of 30-day and long-term mortality (for 30-day mortality, RR 1.25, 95% CI 1.03-1.52, p = 0.02; for long-term mortality, RR 1.45, 95% CI 1.20-1.76, p < 0.01). In conclusion, our findings suggested elevated HbA 1c level among STEMI patients was an indicator of 1.25-fold 30-day mortality risk and 1.45-fold long-term mortality risk, respectively. STEMI patients with high HbA 1c level should have their chronic glucose dysregulation under intensive control.

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“…Diabetes is a major factor for poor outcome in patients with cardiovascular disease [17,18]. In patients with established HF, the prognostic effect of diabetes mellitus is less clear.…”

Section: Introductionmentioning

confidence: 99%

Prevalent Diabetes Mellitus: Mortality and Management in Norwegian Heart Failure Outpatients

Stubnova

Os²,

Grundtvig³

et al. 2016

Cardiology

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Objectives: Heart failure (HF) patients with diabetes mellitus experience poor prognosis. We assessed the independent predictive effect of prevalent diabetes mellitus on all-cause mortality in HF outpatients. Furthermore, we investigated if optimized HF medication differed in diabetic versus nondiabetic patients. Methods: From 6,289 patients included in the Norwegian HF registry during 2000-2012, 724 diabetic HF outpatients were propensity-score-matched with nondiabetic HF outpatients (1:1), based on 21 measured baseline variables. Baseline characteristics, measured comorbidities and medication were balanced in the matched sample. Results: Diabetes was not an independent predictor of all-cause mortality in the propensity-matched analyses (hazard ratio 1.041; 95% confidence interval 0.875-1.240). No interactions were found between the prognostic impact of diabetes and the strata renal function, systolic function or etiology of chronic HF. Diabetic HF outpatients were independently prescribed higher doses of β-blockers and loop diuretics (both p < 0.001) and were more prone to receive statins (p = 0.003) than nondiabetics. Conclusions: Prevalent diabetes mellitus was not an independent predictor of all-cause mortality in HF outpatients. Explanations other than tight glycemic control should be assessed to improve the prognosis of diabetic HF outpatients. The more intensive, optimized HF medication for diabetic HF outpatients may, to a certain degree, explain our results.

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Impact of Diabetes Mellitus on Clinical Characteristics, Management, and In-hospital Outcomes in Patients With Acute Myocardial Infarction (from the NCDR)

Cited by 44 publications

References 30 publications

Comparison of Immediate With Delayed Stenting Using the Minimalist Immediate Mechanical Intervention Approach in Acute ST-Segment–Elevation Myocardial Infarction

Comparison of Immediate With Delayed Stenting Using the Minimalist Immediate Mechanical Intervention Approach in Acute ST-Segment–Elevation Myocardial Infarction

Prognostic value of glycated hemoglobin among patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis

Prevalent Diabetes Mellitus: Mortality and Management in Norwegian Heart Failure Outpatients

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