Original Research Article I Volume 11 I Issue 4 I 2023
Outcome Differences in Diabetic and Non-Diabetic Following Primary PCI In Stemi Patients
Peter Atef Basta Samwel, Salah Mohamed Eltahan, Sherif Wagdy Ayad
Biolife, Volume 11, Issue 4, 2023, pp 19-26
DOI:https://doi.org/10.5281/zenodo.10273912
Abstract:
The purpose of this study is to determine the outcome and associated Major Adverse Cardiac Events (successful or failed primary percutaneous coronary intervention (PCI), complicated primary PCI, heart failure, cardiac arrest, ventricular tachycardia (VT), ventricular fibrillation (VF), renal failure, shock) within six months in diabetic and non- diabetic patients presenting with ST- segment elevation myocardial infarction and treated by primary percutaneous coronary interventions. This prospective study was conducted to include one hundred and nine patients with ST-segment elevation myocardial infarction (STEMI) admitted to the emergency department (ED) of Alexandria Main University Hospital (AMUH) and International Cardiac Centre (ICC) that are going to do primary PCI divided into two groups; diabetic group fifty nine patients and non-diabetic group fifty patients. History taking, clinical examination, laboratory investigations and radiological investigations including Echo cardiography done for those patients. The frequency of MACE among the diabetic group was 69.8% and among the non-diabetic group was 30.2%, so there was statistically significant difference between diabetic and non-diabetic groups (p<0.001). In this study, it was noted that despite of reperfusion therapy, STEMI patients with diabetes have an increased the risk of MACE and adverse prognosis. Mortality remain substantially higher in patients with diabetes following primary PCI for STEMI in comparison with those without diabetes and presence of diabetes which highlights the importance of aggressive strategies to manage the high risk population with acute MI
Keywords:
Diabetes mellitus, ST-segment elevation myocardial infarction, Primary percutaneous coronary intervention, Major advanced cardiac events.
References:
[1] Grech ED, Ramsdale DR. Acute coronary syndrome: unstable angina and non-ST segment elevation myocardial infarction. BMJ 2003; 326: 1259–61.
[2] Armstrong PW, Fu Y, Chang WC, Topol EJ, Granger CB, Betriu A, et al. Acute coronary syndromes in the GUSTO-IIb trial: prognostic insights and impact of recurrent ischemia. The GUSTO-IIb Investigators. Circulation 1998; 98: 1860–8.
[3] Jollis JG, Granger CB, Henry TD, Antman EM, Berger PB, Moyer PH, et al. Systems of care for ST-segment-elevation myocardial infarction: a report from the American Heart Association’s Mission: Lifeline. Circ Cardiovasc Qual Outcomes 2012; 5: 423–8.
[4] Victor SM, Gnanaraj ASV, Pattabiram S, Mullasari AS. Door-to-balloon: where do we lose time? Single center experience in India. Indian Heart J 2012; 64: 582–7.
[5] Park YH, Kang GH, Song BG, Chun WJ, Lee JH, Hwang SY, et al. Factors related to prehospital time delay in acute ST-segment elevation myocardial infarction. J Korean Med Sci 2012; 27: 864–9.
[6] Palmerini T, Biondi-Zoccai G, Reggiani LB, Sangiorgi D, Alessi L, De Servi S, et al. Risk of Stroke With Coronary Artery Bypass Graft Surgery Compared With Percutaneous Coronary Intervention. J Am Coll Cardiol 2012; 60: 798-805.
[7] Creager MA, Luscher TF, Cosentino F, Beckman JA. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part I. Circulation 2003;108:1527-32.
[8] Andersen HR, Nielsen TT, Rasmussen K, Thuesen L, Kelbaek H, Thayssen P, et al. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction. N Engl J Med 2003; 349: 733–42.
[9] Keeley EC, Boura JA, Grines CL. Comparison of primary and facilitated percutaneous coronary interventions for ST-elevation myocardial infarction: quantitative review of randomised trials. Lancet 2006; 367: 579–88.
[10] De Luca G, Gibson CM, Bellandi F, Noc M, Dudek D, Zeymer U, et al. Diabetes mellitus is associated with distal embolization, impaired myocardial perfusion, and higher mortality in patients with ST-segment elevation myocardial infarction treated with primary angioplasty and glycoprotein IIb-IIIa inhibitors. Atherosclerosis 2009; 207: 181–5.
Article Dates:
Received: 21 October 2023; Accepted: 2 December 2023: Published online: 6 December 2023
How To Cite:
Peter Atef Basta Samwel, Salah Mohamed Eltahan, Sherif Wagdy Ayad (2023). Outcome Differences in Diabetic and Non-Diabetic Following Primary PCI In Stemi Patients. Biolife. 11(4), 19-26. DOI: https://dx.doi.org/10.5281/zenodo.10273912
