Informace o publikaci

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

Autoři	GIUSEPPE De Luca ALGOWHARY Magdy UGUZ Berat OLIVEIRA Dinaldo C GANYUKOV Vladimir ZIMBAKOV Zan CERCEK Miha JENSEN Lisette Okkels LOH Poay Huan CALMAC Lucian GERARD Roura i Ferrer QUADROS Alexandre MILEWSKI Marek D'UCCIO Fortunato Scotto CLEMENS von Birgelen VERSACI Francesco JURRIEN Ten Berg CASELLA Gianni LUNG Aaron Wong Sung KALA Petr GIL Jose Luis Diez CARRILLO Xavier DIRKSEN Maurits BECERRA-MUNOZ Victor M LEE Michael Kang-yin JUZAR Dafsah Arifa JOAQUIM Rodrigo de Moura PALADINO Roberto MILICIC Davor DAVLOUROS Periklis BAKRACESKI Nikola ZILIO Filippo DONAZZAN Luca KRAAIJEVELD Adriaan GALASSO Gennaro ARPAD Lux LUCIA Marinucci VINCENZO Guiducci MENICHELLI Maurizio SCOCCIA Alessandra YAMAC Aylin Hatice MERT Kadir Ugur RIOS Xacobe Flores KOVARNIK Tomas KIDAWA Michal MOREU Jose FLAVIEN Vincent FABRIS Enrico MARTINEZ-LUENGAS Inigo Lozano OJEDA Francisco Bosa RODRIGUEZ-SANCHEZ Robert CAIAZZO Gianluca CIRRINCIONE Giuseppe KAO Hsien-Li FORES Juan Sanchis VIGNALI Luigi PEREIRA Helder MANZO Stephane ORDONEZ Santiago OZKAN Alev Arat SCHELLER Bruno LEHTOLA Heidi TELES Rui MANTIS Christos ANTTI Ylitalo SILVEIRA Joao Antonio Brum ZONI Rodrigo BESSONOV Ivan SAVONITTO Stefano KOCHIADAKIS George ALEXOPULOS Dimitrios URIBE Carlos E KANAKAKIS John FAURIE Benjamin GABRIELLI Gabriele BARRIOS Alejandro Gutierrez BACHINI Juan Pablo ROCHA Alex TAM Frankie Chor-Cheung RODRIGUEZ Alfredo LUKITO Antonia Anna BELLEMAIN-APPAIX Anne PESSAH Gustavo CORTESE Giuliana PARODI Guido BURGADHA Mohammed Abed KEDHI Elvin LAMELAS Pablo SURYAPRANATA Harry NARDIN Matteo VERDOIA Monica
Rok publikování	2025
Druh	Článek v odborném periodiku
Časopis / Zdroj	NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
Fakulta / Pracoviště MU	Lékařská fakulta
Citace
www	https://www.sciencedirect.com/science/article/pii/S093947532400382X?via%3Dihub
Doi	https://doi.org/10.1016/j.numecd.2024.09.031
Klíčová slova	Diabetes mellitus; ST-Segment myocardial infarction; PCI; COVID
Popis	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.