Trends in postacute myocardial infarction management and mortality in patients with diabetes. A population-based study from 1995 to 2001

Ouhoummane, Najwa; Abdous, Belkacem; Louchini, Rabia; Rochette, Louis; Poirier, Paul

doi:10.1016/s0828-282x(10)70465-7

Cited by 12 publications

(14 citation statements)

References 50 publications

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“…Our national results are consistent with other studies indicating that PCI rates have increased significantly due to advances in stent device technology and adjunctive pharmacology and CABG rates have declined due to the fact that this procedure is more invasive than PCI procedures [14,21,22]. Rana et al indicated that drug-eluting stents were used more often in patients with severe comorbidities and multivessel disease [23], but a recent study indicated that CABG in patients with diabetes and coronary artery disease offers advantages in terms of survival [24].…”

Section: Discussionsupporting

confidence: 91%

National trends in utilization and outcomes of coronary revascularization procedures among people with and without type 2 diabetes in Spain (2001–2011)

López‐de‐Andrés

Jiménez‐García

Hernández‐Barrera

et al. 2014

Cardiovasc Diabetol

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BackgroundDiabetes is associated with a high risk of death due to coronary artery disease (CAD). People with diabetes suffering from CAD are frequently treated with revascularization procedures. We aim to compare trends in the use and outcomes of coronary revascularization procedures in diabetic and non-diabetic patients in Spain between 2001 and 2011.MethodsWe identified all patients who had undergone coronary revascularization procedures, percutaneous coronary interventions (PCI) and coronary artery bypass graft (CABG) surgeries, using national hospital discharge data. Discharges were grouped by diabetes status: type 2 diabetes and no diabetes. The incidence of discharges attributed to coronary revascularization procedures were calculated stratified by diabetes status. We calculated length of stay and in-hospital mortality (IHM). We apply joinpoint log-linear regression to identify the years in which changes in tendency occurred in the use of PCI and CABG in diabetic and non-diabetic patients. Multivariate analysis was adjusted by age, sex, year and comorbidity (Charlson comorbidity index).ResultsFrom 2001 to 2011, 434,108 PCIs and 79,986 CABGs were performed. According to the results of the joinpoint analysis, we found that sex and age-adjusted use of PCI increased by 31.4% per year from 2001 to 2003, by 15.9% per year from 2003 to 2006 and by 3.8% per year from 2006 to 2011 in patients with diabetes. IHM among patients with diabetes who underwent a PCI did not change significantly over the entire study period (OR 0.99; 95% CI 0.97-1.00).Among patients with diabetes who underwent a CABG, the sex and age-adjusted CABG incidence rate increased by 10.4% per year from 2001 to 2003, and then decreased by 1.1% through 2011. Diabetic patients who underwent a CABG had a 0.67 (95% CI 0.63-0.71) times lower probability of dying during hospitalization than those without diabetes.ConclusionsThe annual percent change in PCI procedures increased in diabetic and non-diabetic patients. Higher comorbidity and the female gender are associated with a higher IHM in PCI procedures. In diabetic and non-diabetic patients, we found a decrease in the use of CABG procedures. IHM was higher in patients without diabetes than in those with diabetes.

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Section: Discussionsupporting

confidence: 91%

National trends in utilization and outcomes of coronary revascularization procedures among people with and without type 2 diabetes in Spain (2001–2011)

López‐de‐Andrés

Jiménez‐García

Hernández‐Barrera

et al. 2014

Cardiovasc Diabetol

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“…Relatively few studies have evaluated temporal trends in (long-term) mortality of MI patients with and without diabetes (9,11,14). Moreover, the results of these studies were inconsistent.…”

Section: Discussionmentioning

confidence: 99%

Short- and Long-Term Mortality After Myocardial Infarction in Patients With and Without Diabetes

et al. 2012

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OBJECTIVETo study temporal trends in short- and long-term outcome after myocardial infarction (MI) according to diabetes status.RESEARCH DESIGN AND METHODSWe included all 14,434 consecutive patients admitted for ST-segment elevation MI or non–ST-segment elevation MI at our center between 1985 and 2008. The study patients were compared according to prevalent diabetes. Temporal trend analyses were performed by comparing decades of admission (1985–1989 vs. 1990–1999 vs. 2000–2008).RESULTSA total of 2,015 (14%) of the patients had prevalent diabetes. The risk of presenting with diabetes increased from 8 to 17% from 1985 to 2008. Diabetic patients presented with a higher prevalence of cardiovascular risk factors. With time, the use of evidence-based therapies increased in both patients with and without diabetes. Diabetes is associated with a 1.5-fold increased risk of mortality at the 20-year follow-up. Ten-year mortality decreased over time in patients with diabetes, from 53% in 1985–1989 to 39% in 2000–2008 (adjusted hazard ratio 0.56 [95% CI 0.43–0.73]), and in those without diabetes, from 38% in 1985–1989 to 29% in 2000–2008 (0.66 [0.60–0.73]; P interaction = 0.83). Patients with diabetes benefitted from a higher 30-day and 10-year absolute survival increase.CONCLUSIONSTemporal mortality reductions after MI between 1985 and 2008 were at least as high in patients with diabetes compared with those without diabetes. However, long-term mortality remained higher in diabetic patients. Awareness of the high-risk profile of diabetic patients is warranted and might stimulate optimal medical care and outcome.

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“…A number of studies have shown that the prospective risk of adverse cardiovascular events in diabetic individuals without previous myocardial infarctionis comparable to non-diabetic individuals with myocardial infarction, with comparatively worse clinical outcomes for diabetic individuals following an adverse cardiovascular event [1][2][3][4]. Furthermore, population studies indicate that diabetes amplifies the effects of other common CVD risk factors, including hypertension, hypercholesterolemia, and smoking [5,6].…”

Section: Introductionmentioning

confidence: 99%

Dysfunctional HDL and Cardiovascular Disease Risk in Individuals with Diabetic Dyslipidemia

Elboudwarej¹

2012

J Diabetes Metab

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Trends in postacute myocardial infarction management and mortality in patients with diabetes. A population-based study from 1995 to 2001

Cited by 12 publications

References 50 publications

National trends in utilization and outcomes of coronary revascularization procedures among people with and without type 2 diabetes in Spain (2001–2011)

National trends in utilization and outcomes of coronary revascularization procedures among people with and without type 2 diabetes in Spain (2001–2011)

Short- and Long-Term Mortality After Myocardial Infarction in Patients With and Without Diabetes

Dysfunctional HDL and Cardiovascular Disease Risk in Individuals with Diabetic Dyslipidemia

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