Diabetes mellitus is not independently associated with mortality in elderly patients with ST-segment elevation myocardial infarction. Insights from theCodi Infartregistry
Por:
Gual, M, Ariza-Sole, A, Formiga, F, Carrillo, X, Baneras, J, Tizon, H, Garcia-Picart, J, Cardenas, M, Regueiro, A, Tomas, C, Rojas, S, Munoz-Camacho, JF, Rosas, A, Sanchez-Salado, JC, Lorente, V, Roura, G, Alegre, O, Gomez-Hospital, JA, Lidon, RM and Cequier, A
Publicada:
1 ene 2020
Resumen:
Background Diabetes mellitus predicts poorer outcomes in patients with acute coronary syndrome (ACS), but the magnitude of this association in patients at older ages remains controversial. Methods Data were extracted from theCodi Infartdatabase. All consecutive patients with diagnosis of ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) between 2010 and 2015 were included. We assessed the impact of diabetes mellitus on 30-day and one-year mortality in patients aged less than and at least 75 years. Results A total of 12 792 cases were registered, of whom 3023 (23.6%) were aged at least 75 years. About 20% patients had previous diabetes mellitus diagnosis. Patients aged at least 75 years had higher prevalence of comorbidities, higher proportion of heart failure at admission, a more extensive coronary artery disease and significant delay to reperfusion (P< 0.001). Diabetes mellitus was associated with higher 30-day mortality both in young [odds ratio (OR) 1.97, 95% confidence interval (CI): 1.43-2.70] and in elderly patients (OR 1.43, 95% CI: 1.07-1.91). After adjusting for potential confounders, this association remained significant in young patients (OR 1.47, 95% CI: 1.00-2.16,P= 0.047), but not in the elderly (OR 1.14,P= 0.43). Likewise, a crude association between diabetes mellitus and one-year mortality was observed in both groups (young patients: HR = 1.93; 95% CI: 1.51-2.46; older patients: HR = 1.33; 95% CI: 1.08-1.64). However, after adjusting for potential confounders, this association remained significant in younger patients (HR = 1.46; 95% CI: 1.13-1.89;P< 0.001), but not in the elderly (HR = 1.16;P= 0.17). Conclusion A significant proportion of these nonselected patients with STEMI had previous diabetes mellitus. The association between diabetes mellitus and outcomes is different according to age.
Filiaciones:
Gual, M:
Hosp Univ Bellvitge, Barcelona, Spain
Ariza-Sole, A:
Hosp Univ Bellvitge, Barcelona, Spain
Formiga, F:
Hosp Univ Bellvitge, Barcelona, Spain
:
Hosp Univ Germans Trias i Pujol Badalona, Barcelona, Spain
Baneras, J:
Hosp Univ Vall dHebron, Barcelona, Spain
Tizon, H:
Hosp Mar, Barcelona, Spain
IMIM Inst Hosp del Mar Invest Med, Grp Recerca Biomed Malalties Cor, Barcelona, Spain
Garcia-Picart, J:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Cardenas, M:
Hosp Unversitari Josep Trueta, Girona, Spain
Regueiro, A:
Hosp Clin & Provicial, Barcelona, Spain
Tomas, C:
Hosp Arnau Vilanova, Lleida, Spain
Rojas, S:
Hosp Joan 23, Tarragona, Spain
Munoz-Camacho, JF:
Hosp Mutua Terrassa, Barcelona, Spain
Rosas, A:
Generalitat Catalunya, Dept Salut, Barcelona, Spain
Sanchez-Salado, JC:
Hosp Univ Bellvitge, Barcelona, Spain
Lorente, V:
Hosp Univ Bellvitge, Barcelona, Spain
Roura, G:
Hosp Univ Bellvitge, Barcelona, Spain
Alegre, O:
Hosp Univ Bellvitge, Barcelona, Spain
Gomez-Hospital, JA:
Hosp Univ Bellvitge, Barcelona, Spain
Lidon, RM:
Hosp Univ Vall dHebron, Barcelona, Spain
Cequier, A:
Hosp Univ Bellvitge, Barcelona, Spain
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