The purpose of the present study was to examine the influence of diabetes mellitus
(DM) on the clinical outcome in patients with acute myocardial infarction (MI)
treated with primary coronary stenting within 24 h of the onset of symptoms.
Methods
We enrolled 100 patients (50 diabetics and 50 nondiabetics) admitted to the
coronary care units of Benha University hospitals and National Heart Institute
from January 2015 to December 2015 with acute MI treated with primary coronary
stenting within 24 h of the onset of symptoms. Clinical outcome was observed in
every patient for major adverse cardiac events and hospital stay. Echocardiography
was also performed before the patient’s discharge from the hospital. Patients were
followed up at 3 months for the occurrence of major adverse cardiac events.
Results
The diabetic patients showed higher incidence of hypertension (P=0.003), renal
impairment (P=0.045) and dyslipidemia (P=0.05) and also higher incidence of
heart failure (P=0.013) during admission and higher mean serum creatinine kinase
MB mass assay levels (P=0.005). There were no statistically significant differences
in other variables. Procedural success was similar in the two groups. With regard to
in-hospital clinical course, diabetic patients were more likely to have early post-MI
heart failure (P=0.013), target vessel revascularization (P=0.037) and longer
hospital stay (P=0.019). At 3 months, diabetic patients were significantly more
likely to experience revascularization (P=0.045) and were more likely to be
rehospitalized for acute coronary syndrome and decompensated heart failure
(P=0.037); however, there was no significant difference in mortality (P=0.307).
Conclusion
Compared with nondiabetics, diabetic patients are more likely to have early post-MI
heart failure, target vessel revascularization, and longer hospital stay. Moreover,
diabetic patients are significantly more likely to experience revascularization and
are more likely to be rehospitalized for acute coronary syndrome or decompensated
heart failure |
