The influence of diabetes on left ventricular remodeling after primary percutaneous coronary intervention for patients with acute myocardial infarction
10.3969/j.issn.1004-8812.2014.05.003
- VernacularTitle:糖尿病对急性心肌梗死患者直接经皮冠状动脉介入治疗后左心室重构的影响
- Author:
Qi ZHANG
;
Ruiyan ZHANG
;
Jian HU
;
Zhenkun YANG
;
Fenghua DING
;
Tianqi ZHU
;
Zhengbin ZHU
;
Weifeng SHEN
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Percutaneous coronary intervention;
Left ventricular remodeling;
Diabetes mellitus
- From:
Chinese Journal of Interventional Cardiology
2014;(5):283-287
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influence of diabetes mellitus (DM) on left ventricular(LV) remodeling in patients with acute ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI) within 12 hours of symptom onset. Methods Four hundred and fifty-one consecutive patients with acute STEMI treated by primary PCI were prospectively enrolled in the current study. Baseline, angiographic and PCI features and prevalence of LV remodeling at one-week during hospitalization and 6-month clinical follow-up by two-dimensional echocardiography were compared between 93 diabetic and 358 non-diabetic patients. Results Despite similar baseline clinical and angiographic characteristics, symptom-to-door time was longer (399±106 min vs. 321±116 min, P=0.006) and prevalence of multivessel disease was higher (65.6%vs. 51.7%, P=0.02) in diabetic patients. More patients in diabetic group had LV remodeling at 6-month clinical follow-up (29.0%vs. 17.3%, P=0.01), and DM was an independent predictor of LV remodeling (RR 2.1, 95%CI 1.31-4.79, P=0.02). The rate of rehospitalization due to heart failure did not differ between diabetic and non-diabetic patients (12.9%vs. 8.1%, P=0.15), however, more adverse events occurred in patients with LV remodeling comparing to those without LV remodeling (25.8% vs. 6.6%, P < 0.001). Conclusions Diabetic patients with STEMI often have an increased risk of LV remodeling after treated by primary PCI. Thus, comprehensive therapeutic strategy for diabetic patients presented with STEMI is required considering the poor prognosis of these patients with LV remodeling.
