Research Article
Volume 7 Issue 7 - 2020
Long-term Outcomes of Patients with Diabetes Mellitus Undergoing Coronary Revascularization for ST-Segment Elevation Myocardial Infarction: A Single Centre Study
Shanathan Sritharan1, Alexander Dashwood2, Nathaniel Smilowitz3 and Seshasayee Narasimhan1,2,4,5*
1Divison of Cardiovascular Medicine, Manning Base Hospital, Taree, Australia
2Division of Cardiovascular Medicine, Gold Coast University Hospital, Southport, Australia
3Division of Cardiology, NYU School of Medicine, NY, USA
4School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
5School of Rural Medicine, University of New England, Armidale, Australia
*Corresponding Author: Seshasayee Narasimhan, Divison of Cardiovascular Medicine, Manning Base Hospital, Taree, Australia.
Received: May 28, 2020; Published: June 22, 2020




Abstract

Diabetes mellitus (DM) is a major risk factor for coronary artery disease (CAD) and is associated with a higher incidence of myocardial infarction (MI) and sudden cardiac death (SCD). Patients with DM have higher mortality during the acute period of acute coronary syndrome (ACS), greater morbidity during the postinfarction recovery phase and more frequent re-infarction than patients without DM. Reperfusion therapy with primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) is associated with higher short-term mortality (30-days) in patients with DM when compared with outcomes in patients without DM. The long-term efficacy of reperfusion therapy with thrombolysis is well established, 8,9 but few data are available on long-term outcomes of PCI for STEMI in patients with DM. We therefore sought to determine long-term outcomes of contemporary PCI in STEMI patients with and without DM.

In a single centre series of 273 patients treated for STEMI in the contemporary era, 17.6% of patients had a diagnosis of DM.  Mortality was not different among patients with and without DM at all time points, although the proportion of deaths was numerically greater in DM patients.  Management of STEMI in patients with DM was associated with a trend more frequent AKI. Kidney injury is a significant risk factor for long-term mortality, highlighting the importance of mitigating AKI in patients with DM who present with STEMI.

In the present study, mortality at 3 years after STEMI in patients with DM was 18.9%. There was a trend toward adverse outcomes in patients with STEMI and DM compared to patients without DM, although due to the small sample size, none of the comparisons met statistical significance. Additional studies to improve outcomes of patients with DM and STEMI are necessary.

Keywords: Diabetes Mellitus; Revascularization; AKI

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Citation: Seshasayee Narasimhan., et al. “Long-term Outcomes of Patients with Diabetes Mellitus Undergoing Coronary Revascularization for ST-Segment Elevation Myocardial Infarction: A Single Centre Study”. EC Cardiology 7.7 (2020): 08-15.

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