Different Impact of Diabetes Mellitus on In-Hospital and 1-Year Mortality in Patients with Acute Myocardial Infarction Who Underwent Successful Percutaneous Coronary Intervention: Results from the Korean Acute Myocardial Infarction Registry.
10.3904/kjim.2012.27.2.180
- Author:
Keun Ho PARK
1
;
Youngkeun AHN
;
Myung Ho JEONG
;
Shung Chull CHAE
;
Seung Ho HUR
;
Young Jo KIM
;
In Whan SEONG
;
Jei Keon CHAE
;
Taek Jong HONG
;
Myeong Chan CHO
;
Jang Ho BAE
;
Seung Woon RHA
;
Yang Soo JANG
Author Information
1. Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea. cecilyk@hanmail.net
- Publication Type:Original Article ; Comparative Study ; Multicenter Study ; Research Support, Non-U.S. Gov't
- Keywords:
Diabetes mellitus;
Myocardial infarction;
Mortality
- MeSH:
Aged;
Angioplasty, Balloon, Coronary/adverse effects/*mortality;
Chi-Square Distribution;
Diabetes Mellitus/*mortality;
Female;
Hospital Mortality;
Humans;
Kaplan-Meier Estimate;
Logistic Models;
Male;
Middle Aged;
Multivariate Analysis;
Myocardial Infarction/mortality/*therapy;
Proportional Hazards Models;
Prospective Studies;
Registries;
Republic of Korea;
Risk Assessment;
Risk Factors;
Time Factors;
Treatment Outcome
- From:The Korean Journal of Internal Medicine
2012;27(2):180-188
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The aim of this study was to evaluate the impact of diabetes mellitus (DM) on in-hospital and 1-year mortality in patients who suffered acute myocardial infarction (AMI) and underwent successful percutaneous coronary intervention (PCI). METHODS: Among 5,074 consecutive patients from the Korea AMI Registry with successful revascularization between November 2005 and June 2007, 1,412 patients had a history of DM. RESULTS: The DM group had a higher mean age prevalence of history of hypertension, dyslipidemia, ischemic heart disease, high Killip class, and diagnoses as non-ST elevation MI than the non-DM group. Left ventricular ejection fraction (LVEF) and creatinine clearance were lower in the DM group, which also had a significantly higher incidence of in-hospital and 1-year mortality of hospital survivors (4.6% vs. 2.8%, p = 0.002; 5.0% vs. 2.5%, p < 0.001). A multivariate analysis revealed that independent predictors of in-hospital mortality were Killip class IV or III at admission, use of angiotensin converting enzyme inhibitors or angiotensin-II receptor blockers, LVEF, creatinine clearance, and a diagnosis of ST-elevated MI but not DM. However, a multivariate Cox regression analysis showed that DM was an independent predictor of 1-year mortality (hazard ratio, 1.504; 95% confidence interval, 1.032 to 2.191). CONCLUSIONS: DM has a higher association with 1-year mortality than in-hospital mortality in patients with AMI who underwent successful PCI. Therefore, even when patients with AMI and DM undergo successful PCI, they may require further intensive treatment and continuous attention.
