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  3. Impact of diabetes on epicardial reperfusion and mortality in a contemporary STEMI population undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry

Impact of diabetes on epicardial reperfusion and mortality in a contemporary STEMI population undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • De Luca G.
  • Algowhary M.
  • Uguz B.
  • Oliveira D.C.
  • Ganyukov V.
  • Zimbakov Z.
  • Cercek M.
  • Jensen L.O.
  • Loh P.H.
  • Calmac L.
  • Roura i Ferrer G.
  • Quadros A.
  • Milewski M.
  • D'Uccio F.S.
  • von Birgelen C.
  • Versaci F.
  • Berg J.T.
  • Casella G.
  • Lung A.W.S.
  • Kala P.
  • Carrillo X.
  • Dirksen M.
  • Becerra-Munoz V.M.
  • Lee M.K.-Y.
  • Juzar D.A.
  • Moura Joaquim R.D.
  • Paladino R.
  • Milicic D.
  • Davlouros P.
  • Bakraceski N.
  • Zilio F.
  • Donazzan L.
  • Kraaijeveld A.
  • Galasso G.
  • Arpad L.
  • Lucia M.
  • Vincenzo G.
  • Menichelli M.
  • Scoccia A.
  • Yamac A.H.
  • Mert K.U.
  • Rios X.F.
  • Kovarnik T.
  • Kidawa M.
  • Moreu J.
  • Flavien V.
  • Fabris E.
  • Martínez-Luengas I.L.
  • Ojeda F.B.
  • Rodríguez-Sanchez R.
  • Caiazzo G.
  • Cirrincione G.
  • Kao H.-L.
  • Forés J.S.
  • Vignali L.
  • Pereira H.
  • Manzo S.
  • Ordoñez S.
  • Özkan A.A.
  • Scheller B.
  • Lehtola H.
  • Teles R.
  • Mantis C.
  • Antti Y.
  • Silveira J.A.B.
  • Zoni R.
  • Bessonov I.
  • Savonitto S.
  • Kochiadakis G.
  • Alexopulos D.
  • Uribe C.E.
  • Kanakakis J.
  • Faurie B.
  • Gabrielli G.
  • Gutierrez Barrios A.
  • Bachini J.P.
  • Rocha A.
  • Tam F.C.-C.
  • Rodriguez A.
  • Lukito A.A.
  • Bellemain-Appaix A.
  • Pessah G.
  • Cortese G.
  • Parodi G.
  • Burgadha M.A.
  • Kedhi E.
  • Lamelas P.
  • Suryapranata H.
  • Nardin M.
  • Verdoia M.

Grupos

Abstract

Background and aim: Diabetes has been shown in last decades to be associated with a significantly higher mortality among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI (PPCI). Therefore, the aim of current study was to evaluate the impact of diabetes on times delays, reperfusion and mortality in a contemporary STEMI population undergoing PPCI, including treatment during the COVID pandemic. Methods and results: The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry involving PPCI centers from Europe, Latin America, South-East Asia and North-Africa, including patients treated from 1st of March until June 30, 2019 and 2020. Primary study endpoint of this analysis was in-hospital mortality. Secondary endpoints were postprocedural TIMI 0–2 flow and 30-day mortality. Our population is represented by 16083 STEMI patients. A total of 3812 (23,7 %) patients suffered from diabetes. They were older, more often males as compared to non-diabetes. Diabetic patients were less often active smokers and had less often a positive family history of CAD, but they were more often affected by hypertension and hypercholesterolemia, with higher prevalence of previous STEMI and previous CABG. Diabetic patients had longer ischemia time, had more often anterior MI, cardiogenic shock, rescue PCI and multivessel disease. They had less often out-of-hospital cardiac arrest and in-stent thrombosis, received more often a mechanical support, received less often a coronary stent and DES. Diabetes was associated with a significantly impaired postprocedural TIMI flow (TIMI 0–2: 9.8 % vs 7.2 %, adjusted OR [95 % CI] = 1.17 [1.02–1.38], p = 0.024) and higher mortality (in-hospital: 9.1 % vs 4.8 %, Adjusted OR [95 % CI] = 1.70 [1.43–2.02], p < 0.001; 30-day mortality: 10.8 % vs 6 %, Adjusted HR [95 % CI] = 1.46 [1.26–1.68], p < 0.001) as compared to non-diabetes, particularly during the pandemic. Conclusions: Our study showed that in a contemporary STEMI population undergoing PPCI, diabetes is significantly associated with impaired epicardial reperfusion that translates into higher in-hospital and 30-day mortality, particularly during the pandemic. © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University

Datos de la publicación

ISSN/ISSNe:
0939-4753, 1590-3729

NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES  ELSEVIER SCI LTD

Tipo:
Article
Páginas:
-
PubMed:
39638679
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
1,013 SCImago ℠
Cuartil:
Q1 SCImago ℠

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Keywords

  • Aged; COVID-19; Diabetes Mellitus; Female; Hospital Mortality; Humans; Male; Middle Aged; Percutaneous Coronary Intervention; Registries; Retrospective Studies; Risk Assessment; Risk Factors; ST Elevation Myocardial Infarction; Time Factors; Time-to-Treatment; Treatment Outcome; drug eluting stent; acute heart infarction; adult; aged; angioplasty; Article; artificial ventilation; cardiogenic shock; cardiovascular disease; coronavirus disease 2019; diabetes mellitus; dual antiplatelet therapy; epicardial reperfusion; female; heart arrest; hospitalization; human; hypercholesterolemia; hypertension; in-hospital mortality; longer ischemia time; major clinical study; male; mechanical reperfusion; mortality; mortality rate; multicenter study; outcome assessment; pandemic; percutaneous coronary intervention; prevalence; reperfusion; retrospective study; ST segment elevation myocardial infarction; adverse event; clinical trial; coronavirus disease 2019; diagnosis; epidemiology; hospital mortal

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