Impact of Diabetes on 10-Year Outcomes Following ST-Segment-Elevation Myocardial Infarction : Insights From the EXAMINATION-EXTEND Trial
Spione, Francesco (Hospital Clínic i Provincial de Barcelona)
Arevalos, Victor (Hospital Clínic i Provincial de Barcelona)
Gabani, Rami (Hospital Clínic i Provincial de Barcelona)
Ortega-Paz, Luis (University of Florida College of Medicine)
Gomez Lara, Josep (Hospital Universitari de Bellvitge)
Jimenez-Diaz, Victor (Instituto De Investigación Sanitaria Galicia Sur)
Jimenez, Marcelo (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Jiménez-Quevedo, Pilar (Hospital Clínico San Carlos (Madrid))
Diletti, Roberto (Thoraxcenter (Rotterdam, Països Baixos))
Pineda Rocamora, Javier (Hospital General Universitario de Alicante (Alacant, País Valencià))
Campo, Gianluca (Azienda Ospedaliera Universitaria di Ferrara (Cona, Itàlia))
Silvestro, Antonio (University Hospital Bolognini Seriate (Bergamo, Itàlia))
Maristany, Jaume (Hospital Universitari Son Dureta (Palma de Mallorca, Balears))
Flores, Xacobe (Hospital Universitario A Coruña (Galícia))
Oyarzabal, Loreto (Hospital Universitari de Bellvitge)
Bastos Fernández, Guillermo (Instituto De Investigación Sanitaria Galicia Sur)
Iñiguez, Andrés (Hospital Álvaro Cunqueiro (Vigo))
Serra, Antonio (Institut d'Investigació Biomèdica Sant Pau)
Escaned, Javier (Hospital Clínico San Carlos (Madrid))
Ielasi, Alfonso (University Hospital Bolognini Seriate (Bergamo, Itàlia))
Tespili, Maurizio (University Hospital Bolognini Seriate (Bergamo, Itàlia))
Lenzen, Mattie (Thoraxcenter (Rotterdam, Països Baixos))
Gonzalo, Nieves (Hospital Universitario Clínico San Carlos (Madrid))
Bordes, Pascual (Hospital General Universitario de Alicante (Alacant, País Valencià))
Tebaldi, Matteo (Azienda Ospedaliera Universitaria di Ferrara (Cona, Itàlia))
Biscaglia, Simone (Azienda Ospedaliera Universitaria di Ferrara (Cona, Itàlia))
Al-Shaibani, Soheil (Thoraxcenter (Rotterdam, Països Baixos))
Romaguera, Rafael (Hospital Universitari de Bellvitge)
Gomez-Hospital, Joan Antoni (Hospital Universitari de Bellvitge)
Rodes-Cabau, Josep (Hospital Clínic i Provincial de Barcelona)
Serruys, Patrick W. (National University of Ireland (Galway, Irlanda))
Sabaté Tenas, Manel (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Brugaletta, Salvatore (Hospital Clínic i Provincial de Barcelona)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Long-term outcomes of ST-segment-elevation myocardial infarction in patients with diabetes have been barely investigated. The objective of this analysis from the EXAMINATION-EXTEND (10-Years Follow-Up of the EXAMINATION trial) trial was to compare 10-year outcomes of patients with ST-segment-elevation myocardial infarction with and without diabetes. Of the study population, 258 patients had diabetes and 1240 did not. The primary end point was patient-oriented composite end point of all-cause death, any myocardial infarction, or any revascularization. Secondary end points were the individual components of the primary combined end point, cardiac death, target vessel myocardial infarction, target lesion revascularization, and stent thrombosis. All end points were adjusted for potential confounders. At 10 years, patients with diabetes showed a higher incidence of patient-oriented composite end point compared with those without (46. 5% versus 33. 0%; adjusted hazard ratio [HR], 1. 31 [95% CI, 1. 05-1. 61]; P=0. 016) mainly driven by a higher incidence of any revascularization (24. 4% versus 16. 6%; adjusted HR, 1. 61 [95% CI, 1. 19-2. 17]; P=0. 002). Specifically, patients with diabetes had a higher incidence of any revascularization during the first 5 years of follow-up (20. 2% versus 12. 8%; adjusted HR, 1. 57 [95% CI, 1. 13-2. 19]; P=0. 007) compared with those without diabetes. No statistically significant differences were found with respect to the other end points. Patients with ST-segment-elevation myocardial infarction who had diabetes had worse clinical outcome at 10 years compared with those without diabetes, mainly driven by a higher incidence of any revascularizations in the first 5 years. https://www. clinicaltrials. gov; NCT04462315.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	ST-segment-elevation myocardial infarction ; Diabetes ; Drug-eluting stent ; Percutaneous coronary intervention
Publicado en:	Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol. 11 Núm. 23 (2022) , p. e025885, ISSN 2047-9980

DOI: 10.1161/JAHA.122.025885
PMID: 36444863

9 p, 1.1 MB

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