Author + information
- S1936879815021007-6cf104446f9e4e6393a5bdfc94cf6707Edison Peixoto,
- S1936879815021007-d514ad3bbb6ba8bceeb8e425f37a677eRodrigo Peixoto,
- S1936879815021007-b3bb76d60a5ad7b2b8591a58fe910525Ivana Borges,
- S1936879815021007-e036bc43050c4f0c3ecc9ddd71d83259Ricardo Peixoto,
- S1936879815021007-b72dae550a31bc05d1f215f641166d91Alexandre Aragao and
- S1936879815021007-b4fad75f40972692a4c3e08faacb7137Vanessa Marcolla
Some studies showed that diabetic patients (D) group (DG) had a worse outcome when compared to nondiabetic (ND) patients group (NDG), after primary percutaneous coronary intervention (PCI). The objectives were to compare mortality and major coronary events (MACE) at 30 days and 1 year of DG and NDG submitted to primary PCI and to study whether another conditions were related to worst outcome of patients in 30 days or one year.
Prospective study with 450 consecutive patients submitted to PCI from 01/01/2001 to 12/31/2006 (121 D and 329 ND) with ST-segment elevation acute myocardial infarction (AMI) in the first 12 hours of symptoms presentation treated with balloon catheter or bare metal stent and without cardiogenic shock. We used in statistical analysis: Student t test, chi-square test, Fischer exact test, and multivariate analysis: logistic regression and Cox analysis.
DG and NDG had similar age (63.1±10.0 and 62.3±11.7 years, p=0.443), male gender (63.6% and 69.9%, p=0.205) and multivascular disease (66.1% and 60.8%, p=0.301). The diabetic group had more dyslipidemia (65.3% x 51.7%, p=0.009) and severe left ventricular dysfunction (15.7% x 8.2%, p=0.019). The stent implantation rate was (83.5% and 81.1%, p=0.863) and glycoprotein (GP) IIb/IIIa inhibitors utilization (79.3% and 82.2%, p=0.831) were similar. The mortality at 30 days (2.5% and 2.7%, p=1.000) and at 1 year (5.0% and 6.7%, p=0,650) and MACE at 30 days (4.1% and 6.4%, p=0,496) and at 1 year (19.4% and 15.4%, p=0,3492) were similar. The absence of TIMI III flow after the procedure (procedure failure) was the only independent hospital mortality (30 days) predictor (P<0,001, OR=8,045, CI95 2,327-27,816). Procedure failure (p=0,023, HR=3,364, CI95 1,182-9,578) and age ≥ 65 years (P=0,035, HR=3,391, CI95 1,091-10,543) were independent predictors of mortality at 1 year. The multivessel coronary disease (p=0,023, OR=4,218, CI95 1,223-14,545 and procedure failure (P<0,028, OR 3.155, CI95 1,132-8,799) were independent predictors of MACE at 30 days and multivessel coronary disease was independent of MACE at 1 year (p=0.034, HR=1.854, CI95 1.048-3.280).