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Jiang YJ, Han WX, Gao C, Feng J, Chen ZF, Zhang J, Luo CM, Pan JY. Comparison of clinical outcomes after drug-eluting stent implantation in diabetic versus nondiabetic patients in China: A retrospective study. Medicine (Baltimore) 2017; 96:e6647. [PMID: 28445265 PMCID: PMC5413230 DOI: 10.1097/md.0000000000006647] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Diabetes mellitus (DM) has been proved to be a predictor of adverse outcomes after percutaneous coronary intervention (PCI). Drug-eluting stents (DESs) could reduce the adverse events in DM patients. In this study, we aimed to analyze the clinical outcome after DES implantation in diabetic versus nondiabetic patients in China. Totally, 200 Chinese DM patients and 400 Chinese non-DM patients were enrolled in this retrospective study. Compared with non-DM patients, DM patients were more likely to have a higher incidence of cardiac death (3.5% vs. 1.0%, P = .048), stent thrombosis (2.5% vs. 0.5%, P = .044), target lesion revascularization (6.0% vs. 1.8%, P = .005), target vessel failure (15.5% vs. 8.0%, P < .001), target lesion failure (14.0% vs. 4.3%, P < .001), myocardial infarction (4.5% vs. 1.5%, P = .030), and major adverse cardiac events (12.5% vs. 5.0%, P = .001) at 2-year follow-up. However, the incidence of target vessel revascularization (7.5% vs. 5.5%, P = .340) was similar between DB and non-DB patients. Patients with DB (hazard ratio [HR] = 2.54, P = .001), older than 80 years (HR = 1.33, P = .027) with hypercholesterolemia (HR = 1.03, P < .001), serum creatinine >177 μmol/L (HR = 3.04, P = .011), a history of cerebral vascular accident (HR = 4.29, P = .010), or a history of myocardial infarction (HR = 31.4, P < .001) were more likely to experience adverse events. In China, DM could also be served as an independent predictor of adverse outcomes after DES implantation. These patients should be reexamined more frequently.
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Affiliation(s)
- Yong-Jin Jiang
- Department of Cardiology, the Affiliated Hefei Hospital of Anhui Medical University (The 2nd People's Hospital of Hefei)
| | - Wei-Xing Han
- Department of Cardiology, the first Affiliated Hospital of Anhui Medical University, Hefei, P.R. China
| | - Chao Gao
- Department of Cardiology, the Affiliated Hefei Hospital of Anhui Medical University (The 2nd People's Hospital of Hefei)
| | - Jun Feng
- Department of Cardiology, the Affiliated Hefei Hospital of Anhui Medical University (The 2nd People's Hospital of Hefei)
| | - Zheng-Fei Chen
- Department of Cardiology, the Affiliated Hefei Hospital of Anhui Medical University (The 2nd People's Hospital of Hefei)
| | - Jing Zhang
- Department of Cardiology, the Affiliated Hefei Hospital of Anhui Medical University (The 2nd People's Hospital of Hefei)
| | - Chun-Miao Luo
- Department of Cardiology, the Affiliated Hefei Hospital of Anhui Medical University (The 2nd People's Hospital of Hefei)
| | - Jian-Yuan Pan
- Department of Cardiology, the Affiliated Hefei Hospital of Anhui Medical University (The 2nd People's Hospital of Hefei)
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Zellweger C, Wildi K, Twerenbold R, Reichlin T, Naduvilekoot A, Neuhaus J, Balmelli C, Gabutti M, Al Afify A, Ballarino P, Jäger C, Druey S, Hillinger P, Haaf P, Vilaplana C, Darbouret B, Ebmeyer S, Rubini Gimenez M, Moehring B, Osswald S, Mueller C. Use of copeptin and high-sensitive cardiac troponin T for diagnosis and prognosis in patients with diabetes mellitus and suspected acute myocardial infarction. Int J Cardiol 2015; 190:190-7. [DOI: 10.1016/j.ijcard.2015.04.134] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Revised: 04/09/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
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Conrotto F, D'Ascenzo F, Giordana F, Salizzoni S, Tamburino C, Tarantini G, Presbitero P, Barbanti M, Gasparetto V, Mennuni M, Napodano M, Rossi ML, La Torre M, Ferraro G, Omedè P, Scacciatella P, Marra WG, Colaci C, Biondi-Zoccai G, Moretti C, D'Amico M, Rinaldi M, Gaita F, Marra S. Impact of diabetes mellitus on early and midterm outcomes after transcatheter aortic valve implantation (from a multicenter registry). Am J Cardiol 2014; 113:529-34. [PMID: 24315111 DOI: 10.1016/j.amjcard.2013.10.025] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 10/23/2013] [Accepted: 10/23/2013] [Indexed: 02/05/2023]
Abstract
Several clinical and procedural factors have been identified as predictors of early and midterm events after transcatheter aortic valve implantation (TAVI), but incidence and prognostic impact of diabetes mellitus (DM), especially insulin treated, on short- and midterm outcomes remain to be defined. All consecutive patients who underwent TAVI at our institutions were enrolled and stratified according to DM status. All-cause mortality at 30 days or in hospital and at follow-up was the primary end point, whereas periprocedural complications, rates of myocardial infarction, stroke, and reintervention at follow-up were the secondary ones. All end points were adjudicated according to the Valve Academic Research Consortium definitions. In all, 511 patients were enrolled: 361 without DM, 78 with orally treated DM, and 72 with insulin-treated DM. Orally treated DM patients were more frequently women, whereas insulin-treated DM patients were younger. Thirty-day Valve Academic Research Consortium mortality was not significantly higher in patients with orally treated DM and insulin-treated DM compared with patients without diabetes (6.4%, 9.7%, and 4.7%, p = 0.09). Bleedings, vascular complications, postprocedural acute kidney injury, and periprocedural strokes were not significantly different in the 3 groups. At midterm follow-up (median 400 days), patients with insulin-treated DM had a significantly higher mortality rate (33.3% vs 18.6%, p = 0.01) and higher myocardial infarction incidence (8.3% vs 1.4%, p = 0.002) if compared with patients without diabetes. Strokes and reinterventions at follow-up were similar in the 3 groups. After multivariable adjustment, insulin-treated DM was independently correlated with death (hazard ratio 2, 95% confidence interval 1.3 to 3.3) and myocardial infarction (hazard ratio 3.73, 95% confidence interval 1.1 to 13). In conclusion, DM does not significantly affect rates of complications in patients who underwent TAVI. Insulin-treated DM, but not orally treated DM, is independently associated with death and myocardial infarction at midterm follow-up and should be included into future TAVI-dedicated scores.
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Affiliation(s)
- Federico Conrotto
- Division of Cardiology 2, Città della Salute e della Scienza Hospital, Turin, Italy.
| | - Fabrizio D'Ascenzo
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Francesca Giordana
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Stefano Salizzoni
- Division of Cardiac Surgery, Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Giuseppe Tarantini
- Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | | | - Marco Barbanti
- Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Valeria Gasparetto
- Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Marco Mennuni
- Division of Cardiology, Istituto Humanitas, Milan, Italy
| | - Massimo Napodano
- Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Marco L Rossi
- Division of Cardiology, Istituto Humanitas, Milan, Italy
| | - Michele La Torre
- Division of Cardiac Surgery, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Gaetana Ferraro
- Division of Cardiology 2, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Pierluigi Omedè
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Paolo Scacciatella
- Division of Cardiology 2, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Walter Grosso Marra
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Chiara Colaci
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Claudio Moretti
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Maurizio D'Amico
- Division of Cardiology 2, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Mauro Rinaldi
- Division of Cardiac Surgery, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Fiorenzo Gaita
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Sebastiano Marra
- Division of Cardiology 2, Città della Salute e della Scienza Hospital, Turin, Italy
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Kim HL, Kang SH, Yoon CH, Cho YS, Youn TJ, Cho GY, Chae IH, Kim HS, Chae SC, Cho MC, Kim YJ, Kim JH, Ahn Y, Jeong MH, Choi DJ. Differential prognostic impacts of diabetes over time course after acute myocardial infarction. J Korean Med Sci 2013; 28:1749-55. [PMID: 24339704 PMCID: PMC3857370 DOI: 10.3346/jkms.2013.28.12.1749] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 09/28/2013] [Indexed: 11/20/2022] Open
Abstract
This study was performed to evaluate the effects of diabetes on short- and mid-term clinical outcomes in patients with acute myocardial infarction (AMI). Between October 2005 and December 2009, a total of 22,347 patients with AMI from a nationwide registry was analyzed. At the time point of the day 30 after AMI onset, landmark analyses were performed for the development of major adverse cardiovascular events (MACEs), including death, re-infarction and revascularization. In this cohort, 6,131 patients (27.4%) had diabetes. Short-term MACEs, which occurred within 30 days of AMI onset, were observed in 1,364 patients (6.1%). Among the 30-day survivors (n = 21,604), mid-term MACEs, which occurred between 31 and 365 days after AMI onset, were observed in 1,181 patients (5.4%). After adjustment for potential confounders, diabetes was an independent predictor of mid-term MACEs (HR, 1.25; 95% CI, 1.08-1.45; P = 0.002), but not of short-term MACEs (HR: 1.16; 95% CI: 0.93-1.44; P = 0.167). Diabetes is a poor prognostic factor for mid-term clinical outcomes but not for short-term outcomes in AMI patients. Careful monitoring and intensive care should be considered in diabetic patients, especially following the acute stage of AMI.
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Affiliation(s)
- Hack-Lyoung Kim
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Si-Hyuck Kang
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Chang-Hwan Yoon
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young-Seok Cho
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae-Jin Youn
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Goo-Yeong Cho
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - In-Ho Chae
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyo-Soo Kim
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Shung-Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Myeong-Chan Cho
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Young-Jo Kim
- Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Ju Han Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Dong-Ju Choi
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
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