Different impact of diabetes mellitus on in-hospital and 1-year mortality in patients with acute myocardial infarction who underwent successful percutaneous coronary intervention: Results from the Korean acute myocardial infarction registry

Title
Different impact of diabetes mellitus on in-hospital and 1-year mortality in patients with acute myocardial infarction who underwent successful percutaneous coronary intervention: Results from the Korean acute myocardial infarction registry
Author(s)
김영조박근호[박근호]안영근[안영근]정명호[정명호]채성철[채성철]허승호[허승호]정인환[정인환]채제건[채제건]홍택종[홍택종]조명찬[조명찬]배승운[배승운]장양수[장양수]
Keywords
angiotensin receptor antagonist; beta adrenergic receptor blocking agent; calcium channel blocking agent; dipeptidyl carboxypeptidase inhibitor; acute heart infarction; adult; article; bare metal stent; cause of death; clinical evaluation; controlled study; creatinine clearance; diabetes mellitus; disease association; disease registry; dyslipidemia; female; heart left ventricle ejection fraction; heart muscle revascularization; hospital patient; human; hypertension; ischemic heart disease; major clinical study; male; medical history; non ST segment elevation myocardial infarction; outcome assessment; percutaneous coronary intervention; prediction; survival rate; Aged; Angioplasty, Balloon, Coronary; Chi-Square Distribution; Diabetes Mellitus; Female; Hospital Mortality; Humans; Kaplan-Meier Estimate; Logistic Models; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction; Proportional Hazards Models; Prospective Studies; Registries; Republic of Korea; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome
Issue Date
201206
Citation
Korean Journal of Internal Medicine, v.27, no.2, pp.180 - 188
Abstract
Background/Aims: The aim of this study was to evaluate the impact of diabetes mellitus (DM) on in-hospital and 1-year mortality in patients who suffered acute myocardial infarction (AMI) and underwent successful percutaneous coronary intervention (PCI). Methods: Among 5,074 consecutive patients from the Korea AMI Registry with successful revascularization between November 2005 and June 2007, 1,412 patients had a history of DM. Results: The DM group had a higher mean age prevalence of history of hypertension, dyslipidemia, ischemic heart disease, high Killip class, and diagnoses as non-ST elevation MI than the non-DM group. Left ventricular ejection fraction (LVEF) and creatinine clearance were lower in the DM group, which also had a significantly higher incidence of in-hospital and 1-year mortality of hospital survivors (4.6% vs. 2.8%, p = 0.002; 5.0% vs. 2.5%, p < 0.001). A multivariate analysis revealed that independent predictors of in-hospital mortality were Killip class IV or III at admission, use of angiotensin converting enzyme inhibitors or angiotensin-II receptor blockers, LVEF, creatinine clearance, and a diagnosis of ST-elevated MI but not DM. However, a multivariate Cox regression analysis showed that DM was an independent predictor of 1-year mortality (hazard ratio, 1.504; 95% confidence interval, 1.032 to 2.191). Conclusions: DM has a higher association with 1-year mortality than in-hospital mortality in patients with AMI who underwent successful PCI. Therefore, even when patients with AMI and DM undergo successful PCI, they may require further intensive treatment and continuous attention. ? 2012 The Korean Association of Internal Medicine.
URI
http://hdl.handle.net/YU.REPOSITORY/27987http://dx.doi.org/10.3904/kjim.2012.27.2.180
ISSN
1226-3303
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의과대학 > 내과학교실 > Articles
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