Clinical features and prognosis of patients with acute ST-segment elevation myocardial infarction comorbid with diabetes mellitus
10.3969/j.issn.1004-8812.2018.02.006
- VernacularTitle:急性ST段抬高型心肌梗死合并糖尿病患者的临床特征及预后分析
- Author:
Yi LUAN
1
;
Wei LI
;
Li-Rong WU
;
Xing-De LIU
;
Ping LI
;
Jin-Feng LIANG
;
Bo WEI
;
Zheng SHEN
;
Deng-Hai XIE
;
An-Min LI
;
Yun CHEN
;
Guo-Bao XIONG
;
Hong-Ling WU
;
Dong-Jiang LI
;
Zong-Gang DUAN
Author Information
1. 贵州医科大学附属医院心血管内科
- Keywords:
Diabetes;
Myocardial infarction;
Prognosis
- From:
Chinese Journal of Interventional Cardiology
2018;26(2):87-92
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of patients with acute ST-segment elevation myocardial infarction (STEMI) comorbid with diabetes mellitus (DM) and to analyze the prognosis within 12 months after primary percutaneous coronary intervention (pre-PCI). Methods A total of 375 STEMI patients were divided into the diabetes group (n=140) and the normal blood glucose group(n=235) according to whether they met the diagnostic criteria of DH. The clinical data,characteristics of coronary artery lesions,type of stent implant,rate of coronary slow flow or no-reflow after pre-PCI, and the prognosis within 12 months after PCI of the two groups were investigated.Results Patient in the diabetes group presented with higher mean age ,higher comorbid rates of hypertension , hyperlipidemia and heart function of Killip class Ш and above than patients in the normal blood glucose group (all P<0.05). patients in the diabetes group had higher rates of slow reflow /no-reflow after PCI(12.9% vs.5.5%,P=0.013),higher percentages of 3-ressel disease(40.7% vs. 28.9%,P=0.019)and lef t main lesions(13.6% vs. 7.2%,P=0.044). The in-hospital mortality rates(6.4% vs.1.7%,P=0.020),revascularization rates within 12 months(7.9% vs.0.9%,P=0.001)and incidence of heart failure(7.9% vs. 2.6%,P=0.017)were all higher in the diabetes group. Conclusions STEMI patients comorbid with DM were relatively older, had higher comorbidities of hypertension,hyperlipidemia, three-vessel disease, left main coronary lesions and higher mortality during hospitalization. No significant increase in cardiac death and recurrent myocardial infarction were deserved during the follow-up period. These patients may benefit more from early intervention.
