Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization

Seung Ho Hur, Ki Bum Won, In Cheol Kim, Jang Ho Bae, Dong Ju Choi, Young Keun Ahn, Jong Seon Park, Hyo Soo Kim, Rak Kyeong Choi, Donghoon Choi, Joon Hong Kim, Kyoo Rok Han, Hun Sik Park, So Yeon Choi, Jung Han Yoon, Hyeon Cheol Gwon, Seung Woon Rha, Wooyeong Jang, Jang Whan Bae, Kyung Kuk HwangDo Sun Lim, Kyung Tae Jung, Seok Kyu Oh, Jae Hwan Lee, Eun Seok Shin, Kee Sik Kim

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Abstract

This study assessed the 2-year clinical outcomes of patients with diabetes mellitus (DM) after acute myocardial infarction (AMI) in a cohort of the DIAMOND (DIabetic Acute Myocardial infarctiON Disease) registry. Clinical outcomes were compared between 1088 diabetic AMI patients in the DIAMOND registry after stabilization of MI and 1088 nondiabetic AMI patients from the KORMI (Korean AMI) registry after 1:1 propensity score matching using traditional cardiovascular risk factors. Stabilized patients were defined as patients who did not have any clinical events within 1 month after AMI. Primary outcomes were the 2-year rate of major adverse cardiac events (MACEs), a composite of all-cause death, recurrent MI (re-MI), and target vessel revascularization (TVR). Matched comparisons revealed that diabetic patients exhibited significantly lower left ventricular ejection fraction (LVEF) and estimated glomerular filtration rate and smaller stent size. Diabetic patients exhibited significantly higher 2-year rates of MACE (8.0% vs 3.7%), all-cause death (3.9% vs 1.4%), re-MI (2.8% vs 1.2%), and TVR (3.5% vs 1.3%) than nondiabetic patients (all P<0.01), and higher cumulative rates in Kaplan-Meier analyses of MACE, all-cause death, and TVR (all P<0.05). A multivariate Cox regression analysis revealed that chronic kidney disease, LVEF<35%, and long stent were independent predictors of MACE, and large stent diameter and the use of drug-eluting stents were protective factors against MACE. The 2-year MACE rate beyond 1 month after AMI was significantly higher in DM patients than non-DM patients, and this rate was associated with higher comorbidities, coronary lesions, and procedural characteristics in DM.

Original languageEnglish
Article numbere3882
JournalMedicine (United States)
Volume95
Issue number25
DOIs
Publication statusPublished - 2016 Jun 1

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Myocardial Infarction
Stents
Registries
Cause of Death
Diabetes Mellitus
Cardiomyopathies
Stroke Volume
Propensity Score
Drug-Eluting Stents
Kaplan-Meier Estimate
Glomerular Filtration Rate
Chronic Renal Insufficiency
Comorbidity
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Hur, Seung Ho ; Won, Ki Bum ; Kim, In Cheol ; Bae, Jang Ho ; Choi, Dong Ju ; Ahn, Young Keun ; Park, Jong Seon ; Kim, Hyo Soo ; Choi, Rak Kyeong ; Choi, Donghoon ; Kim, Joon Hong ; Han, Kyoo Rok ; Park, Hun Sik ; Choi, So Yeon ; Yoon, Jung Han ; Gwon, Hyeon Cheol ; Rha, Seung Woon ; Jang, Wooyeong ; Bae, Jang Whan ; Hwang, Kyung Kuk ; Lim, Do Sun ; Jung, Kyung Tae ; Oh, Seok Kyu ; Lee, Jae Hwan ; Shin, Eun Seok ; Kim, Kee Sik. / Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization. In: Medicine (United States). 2016 ; Vol. 95, No. 25.
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title = "Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization",
abstract = "This study assessed the 2-year clinical outcomes of patients with diabetes mellitus (DM) after acute myocardial infarction (AMI) in a cohort of the DIAMOND (DIabetic Acute Myocardial infarctiON Disease) registry. Clinical outcomes were compared between 1088 diabetic AMI patients in the DIAMOND registry after stabilization of MI and 1088 nondiabetic AMI patients from the KORMI (Korean AMI) registry after 1:1 propensity score matching using traditional cardiovascular risk factors. Stabilized patients were defined as patients who did not have any clinical events within 1 month after AMI. Primary outcomes were the 2-year rate of major adverse cardiac events (MACEs), a composite of all-cause death, recurrent MI (re-MI), and target vessel revascularization (TVR). Matched comparisons revealed that diabetic patients exhibited significantly lower left ventricular ejection fraction (LVEF) and estimated glomerular filtration rate and smaller stent size. Diabetic patients exhibited significantly higher 2-year rates of MACE (8.0{\%} vs 3.7{\%}), all-cause death (3.9{\%} vs 1.4{\%}), re-MI (2.8{\%} vs 1.2{\%}), and TVR (3.5{\%} vs 1.3{\%}) than nondiabetic patients (all P<0.01), and higher cumulative rates in Kaplan-Meier analyses of MACE, all-cause death, and TVR (all P<0.05). A multivariate Cox regression analysis revealed that chronic kidney disease, LVEF<35{\%}, and long stent were independent predictors of MACE, and large stent diameter and the use of drug-eluting stents were protective factors against MACE. The 2-year MACE rate beyond 1 month after AMI was significantly higher in DM patients than non-DM patients, and this rate was associated with higher comorbidities, coronary lesions, and procedural characteristics in DM.",
author = "Hur, {Seung Ho} and Won, {Ki Bum} and Kim, {In Cheol} and Bae, {Jang Ho} and Choi, {Dong Ju} and Ahn, {Young Keun} and Park, {Jong Seon} and Kim, {Hyo Soo} and Choi, {Rak Kyeong} and Donghoon Choi and Kim, {Joon Hong} and Han, {Kyoo Rok} and Park, {Hun Sik} and Choi, {So Yeon} and Yoon, {Jung Han} and Gwon, {Hyeon Cheol} and Rha, {Seung Woon} and Wooyeong Jang and Bae, {Jang Whan} and Hwang, {Kyung Kuk} and Lim, {Do Sun} and Jung, {Kyung Tae} and Oh, {Seok Kyu} and Lee, {Jae Hwan} and Shin, {Eun Seok} and Kim, {Kee Sik}",
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doi = "10.1097/MD.0000000000003882",
language = "English",
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journal = "Medicine (United States)",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
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Hur, SH, Won, KB, Kim, IC, Bae, JH, Choi, DJ, Ahn, YK, Park, JS, Kim, HS, Choi, RK, Choi, D, Kim, JH, Han, KR, Park, HS, Choi, SY, Yoon, JH, Gwon, HC, Rha, SW, Jang, W, Bae, JW, Hwang, KK, Lim, DS, Jung, KT, Oh, SK, Lee, JH, Shin, ES & Kim, KS 2016, 'Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization', Medicine (United States), vol. 95, no. 25, e3882. https://doi.org/10.1097/MD.0000000000003882

Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization. / Hur, Seung Ho; Won, Ki Bum; Kim, In Cheol; Bae, Jang Ho; Choi, Dong Ju; Ahn, Young Keun; Park, Jong Seon; Kim, Hyo Soo; Choi, Rak Kyeong; Choi, Donghoon; Kim, Joon Hong; Han, Kyoo Rok; Park, Hun Sik; Choi, So Yeon; Yoon, Jung Han; Gwon, Hyeon Cheol; Rha, Seung Woon; Jang, Wooyeong; Bae, Jang Whan; Hwang, Kyung Kuk; Lim, Do Sun; Jung, Kyung Tae; Oh, Seok Kyu; Lee, Jae Hwan; Shin, Eun Seok; Kim, Kee Sik.

In: Medicine (United States), Vol. 95, No. 25, e3882, 01.06.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization

AU - Hur, Seung Ho

AU - Won, Ki Bum

AU - Kim, In Cheol

AU - Bae, Jang Ho

AU - Choi, Dong Ju

AU - Ahn, Young Keun

AU - Park, Jong Seon

AU - Kim, Hyo Soo

AU - Choi, Rak Kyeong

AU - Choi, Donghoon

AU - Kim, Joon Hong

AU - Han, Kyoo Rok

AU - Park, Hun Sik

AU - Choi, So Yeon

AU - Yoon, Jung Han

AU - Gwon, Hyeon Cheol

AU - Rha, Seung Woon

AU - Jang, Wooyeong

AU - Bae, Jang Whan

AU - Hwang, Kyung Kuk

AU - Lim, Do Sun

AU - Jung, Kyung Tae

AU - Oh, Seok Kyu

AU - Lee, Jae Hwan

AU - Shin, Eun Seok

AU - Kim, Kee Sik

PY - 2016/6/1

Y1 - 2016/6/1

N2 - This study assessed the 2-year clinical outcomes of patients with diabetes mellitus (DM) after acute myocardial infarction (AMI) in a cohort of the DIAMOND (DIabetic Acute Myocardial infarctiON Disease) registry. Clinical outcomes were compared between 1088 diabetic AMI patients in the DIAMOND registry after stabilization of MI and 1088 nondiabetic AMI patients from the KORMI (Korean AMI) registry after 1:1 propensity score matching using traditional cardiovascular risk factors. Stabilized patients were defined as patients who did not have any clinical events within 1 month after AMI. Primary outcomes were the 2-year rate of major adverse cardiac events (MACEs), a composite of all-cause death, recurrent MI (re-MI), and target vessel revascularization (TVR). Matched comparisons revealed that diabetic patients exhibited significantly lower left ventricular ejection fraction (LVEF) and estimated glomerular filtration rate and smaller stent size. Diabetic patients exhibited significantly higher 2-year rates of MACE (8.0% vs 3.7%), all-cause death (3.9% vs 1.4%), re-MI (2.8% vs 1.2%), and TVR (3.5% vs 1.3%) than nondiabetic patients (all P<0.01), and higher cumulative rates in Kaplan-Meier analyses of MACE, all-cause death, and TVR (all P<0.05). A multivariate Cox regression analysis revealed that chronic kidney disease, LVEF<35%, and long stent were independent predictors of MACE, and large stent diameter and the use of drug-eluting stents were protective factors against MACE. The 2-year MACE rate beyond 1 month after AMI was significantly higher in DM patients than non-DM patients, and this rate was associated with higher comorbidities, coronary lesions, and procedural characteristics in DM.

AB - This study assessed the 2-year clinical outcomes of patients with diabetes mellitus (DM) after acute myocardial infarction (AMI) in a cohort of the DIAMOND (DIabetic Acute Myocardial infarctiON Disease) registry. Clinical outcomes were compared between 1088 diabetic AMI patients in the DIAMOND registry after stabilization of MI and 1088 nondiabetic AMI patients from the KORMI (Korean AMI) registry after 1:1 propensity score matching using traditional cardiovascular risk factors. Stabilized patients were defined as patients who did not have any clinical events within 1 month after AMI. Primary outcomes were the 2-year rate of major adverse cardiac events (MACEs), a composite of all-cause death, recurrent MI (re-MI), and target vessel revascularization (TVR). Matched comparisons revealed that diabetic patients exhibited significantly lower left ventricular ejection fraction (LVEF) and estimated glomerular filtration rate and smaller stent size. Diabetic patients exhibited significantly higher 2-year rates of MACE (8.0% vs 3.7%), all-cause death (3.9% vs 1.4%), re-MI (2.8% vs 1.2%), and TVR (3.5% vs 1.3%) than nondiabetic patients (all P<0.01), and higher cumulative rates in Kaplan-Meier analyses of MACE, all-cause death, and TVR (all P<0.05). A multivariate Cox regression analysis revealed that chronic kidney disease, LVEF<35%, and long stent were independent predictors of MACE, and large stent diameter and the use of drug-eluting stents were protective factors against MACE. The 2-year MACE rate beyond 1 month after AMI was significantly higher in DM patients than non-DM patients, and this rate was associated with higher comorbidities, coronary lesions, and procedural characteristics in DM.

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