Which is the worst risk factor for the long-term clinical outcome? Comparison of long-term clinical outcomes between antecedent hypertension and diabetes mellitus in South Korean acute myocardial infarction patients after stent implantation

Yong Hoon Kim, Ae Young Her, Myung Ho Jeong, Byeong Keuk Kim, Sung Jin Hong, Seunghwan Kim, Chul Min Ahn, Jung Sun Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, Yangsoo Jang

Research output: Contribution to journalArticle

Abstract

Background: Hypertension and diabetes mellitus (DM) are major risk factors for the cardiovascular disease. In this retrospective cohort study, we compared the long-term clinical outcomes between antecedent hypertension and DM in acute myocardial infarction (AMI) patients after stent implantation. Methods: A total of 32 938 eligible AMI patients were enrolled and divided into the four groups according to the presence or absence of hypertension and DM (hypertension −/DM −[group A, 13 773 patients], hypertension +/DM −[group B, 10 395 patients], hypertension −/DM + [group C, 3050 patients], and hypertension +/DM + [group D, 5720 patients]). The clinical endpoint was the cumulative incidence of major adverse cardiac events (MACEs) defined as all-cause death, recurrent myocardial infarction (Re-MI) and any repeat revascularization during the 2-year follow-up period. Results: After adjustment, the cumulative incidence of MACEs (adjusted hazard ratio [aHR], 1.232; 95% confidence interval [CI], 0.982-1.567; P =.071), all-cause death, and e-MI Re-MI were similar between the group B and C. However, the cumulative incidences of any repeat revascularization (aHR, 1.438; 95% CI, 1.062-1.997; P =.007), target lesion revascularization (TLR) (aHR, 2.467; 95% CI, 1.552-3.922; P <.001), and target vessel revascularization (TVR) (aHR, 1.671; 95% CI, 1.256-2.222; P <.001) were significantly higher in group C compared with group B. Conclusions: This large number of a nonrandomized and multicenter cohort study clearly demonstrated the detrimental impacts of the hypertension and diabetes on long-term clinical outcomes. Moreover, higher incidence of repeat revascularization after PCI in diabetic AMI patients a major concern until recently.

Original languageEnglish
JournalJournal of diabetes
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Stents
Diabetes Mellitus
Myocardial Infarction
Hypertension
Confidence Intervals
Incidence
Cause of Death
Cohort Studies
Multicenter Studies
Cardiovascular Diseases
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

@article{5e2fc4f191b24d84b1aa092a509989d5,
title = "Which is the worst risk factor for the long-term clinical outcome? Comparison of long-term clinical outcomes between antecedent hypertension and diabetes mellitus in South Korean acute myocardial infarction patients after stent implantation",
abstract = "Background: Hypertension and diabetes mellitus (DM) are major risk factors for the cardiovascular disease. In this retrospective cohort study, we compared the long-term clinical outcomes between antecedent hypertension and DM in acute myocardial infarction (AMI) patients after stent implantation. Methods: A total of 32 938 eligible AMI patients were enrolled and divided into the four groups according to the presence or absence of hypertension and DM (hypertension −/DM −[group A, 13 773 patients], hypertension +/DM −[group B, 10 395 patients], hypertension −/DM + [group C, 3050 patients], and hypertension +/DM + [group D, 5720 patients]). The clinical endpoint was the cumulative incidence of major adverse cardiac events (MACEs) defined as all-cause death, recurrent myocardial infarction (Re-MI) and any repeat revascularization during the 2-year follow-up period. Results: After adjustment, the cumulative incidence of MACEs (adjusted hazard ratio [aHR], 1.232; 95{\%} confidence interval [CI], 0.982-1.567; P =.071), all-cause death, and e-MI Re-MI were similar between the group B and C. However, the cumulative incidences of any repeat revascularization (aHR, 1.438; 95{\%} CI, 1.062-1.997; P =.007), target lesion revascularization (TLR) (aHR, 2.467; 95{\%} CI, 1.552-3.922; P <.001), and target vessel revascularization (TVR) (aHR, 1.671; 95{\%} CI, 1.256-2.222; P <.001) were significantly higher in group C compared with group B. Conclusions: This large number of a nonrandomized and multicenter cohort study clearly demonstrated the detrimental impacts of the hypertension and diabetes on long-term clinical outcomes. Moreover, higher incidence of repeat revascularization after PCI in diabetic AMI patients a major concern until recently.",
author = "Kim, {Yong Hoon} and Her, {Ae Young} and Jeong, {Myung Ho} and Kim, {Byeong Keuk} and Hong, {Sung Jin} and Seunghwan Kim and Ahn, {Chul Min} and Kim, {Jung Sun} and Ko, {Young Guk} and Donghoon Choi and Hong, {Myeong Ki} and Yangsoo Jang",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/1753-0407.12979",
language = "English",
journal = "Journal of Diabetes",
issn = "1753-0393",
publisher = "Wiley-Blackwell",

}

Which is the worst risk factor for the long-term clinical outcome? Comparison of long-term clinical outcomes between antecedent hypertension and diabetes mellitus in South Korean acute myocardial infarction patients after stent implantation. / Kim, Yong Hoon; Her, Ae Young; Jeong, Myung Ho; Kim, Byeong Keuk; Hong, Sung Jin; Kim, Seunghwan; Ahn, Chul Min; Kim, Jung Sun; Ko, Young Guk; Choi, Donghoon; Hong, Myeong Ki; Jang, Yangsoo.

In: Journal of diabetes, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Which is the worst risk factor for the long-term clinical outcome? Comparison of long-term clinical outcomes between antecedent hypertension and diabetes mellitus in South Korean acute myocardial infarction patients after stent implantation

AU - Kim, Yong Hoon

AU - Her, Ae Young

AU - Jeong, Myung Ho

AU - Kim, Byeong Keuk

AU - Hong, Sung Jin

AU - Kim, Seunghwan

AU - Ahn, Chul Min

AU - Kim, Jung Sun

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Hong, Myeong Ki

AU - Jang, Yangsoo

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Hypertension and diabetes mellitus (DM) are major risk factors for the cardiovascular disease. In this retrospective cohort study, we compared the long-term clinical outcomes between antecedent hypertension and DM in acute myocardial infarction (AMI) patients after stent implantation. Methods: A total of 32 938 eligible AMI patients were enrolled and divided into the four groups according to the presence or absence of hypertension and DM (hypertension −/DM −[group A, 13 773 patients], hypertension +/DM −[group B, 10 395 patients], hypertension −/DM + [group C, 3050 patients], and hypertension +/DM + [group D, 5720 patients]). The clinical endpoint was the cumulative incidence of major adverse cardiac events (MACEs) defined as all-cause death, recurrent myocardial infarction (Re-MI) and any repeat revascularization during the 2-year follow-up period. Results: After adjustment, the cumulative incidence of MACEs (adjusted hazard ratio [aHR], 1.232; 95% confidence interval [CI], 0.982-1.567; P =.071), all-cause death, and e-MI Re-MI were similar between the group B and C. However, the cumulative incidences of any repeat revascularization (aHR, 1.438; 95% CI, 1.062-1.997; P =.007), target lesion revascularization (TLR) (aHR, 2.467; 95% CI, 1.552-3.922; P <.001), and target vessel revascularization (TVR) (aHR, 1.671; 95% CI, 1.256-2.222; P <.001) were significantly higher in group C compared with group B. Conclusions: This large number of a nonrandomized and multicenter cohort study clearly demonstrated the detrimental impacts of the hypertension and diabetes on long-term clinical outcomes. Moreover, higher incidence of repeat revascularization after PCI in diabetic AMI patients a major concern until recently.

AB - Background: Hypertension and diabetes mellitus (DM) are major risk factors for the cardiovascular disease. In this retrospective cohort study, we compared the long-term clinical outcomes between antecedent hypertension and DM in acute myocardial infarction (AMI) patients after stent implantation. Methods: A total of 32 938 eligible AMI patients were enrolled and divided into the four groups according to the presence or absence of hypertension and DM (hypertension −/DM −[group A, 13 773 patients], hypertension +/DM −[group B, 10 395 patients], hypertension −/DM + [group C, 3050 patients], and hypertension +/DM + [group D, 5720 patients]). The clinical endpoint was the cumulative incidence of major adverse cardiac events (MACEs) defined as all-cause death, recurrent myocardial infarction (Re-MI) and any repeat revascularization during the 2-year follow-up period. Results: After adjustment, the cumulative incidence of MACEs (adjusted hazard ratio [aHR], 1.232; 95% confidence interval [CI], 0.982-1.567; P =.071), all-cause death, and e-MI Re-MI were similar between the group B and C. However, the cumulative incidences of any repeat revascularization (aHR, 1.438; 95% CI, 1.062-1.997; P =.007), target lesion revascularization (TLR) (aHR, 2.467; 95% CI, 1.552-3.922; P <.001), and target vessel revascularization (TVR) (aHR, 1.671; 95% CI, 1.256-2.222; P <.001) were significantly higher in group C compared with group B. Conclusions: This large number of a nonrandomized and multicenter cohort study clearly demonstrated the detrimental impacts of the hypertension and diabetes on long-term clinical outcomes. Moreover, higher incidence of repeat revascularization after PCI in diabetic AMI patients a major concern until recently.

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U2 - 10.1111/1753-0407.12979

DO - 10.1111/1753-0407.12979

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JF - Journal of Diabetes

SN - 1753-0393

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