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Effect of diabetes mellitus on periprocedural myocardial infarction in patients undergoing coronary stent implantation
Author(s) -
Verdoia Monica,
Barbieri Lucia,
Schaffer Alon,
Cassetti Ettore,
Di Giovine Gabriella,
Nardin Matteo,
Bellomo Giorgio,
Marino Paolo,
De Luca Giuseppe
Publication year - 2015
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2567
Subject(s) - medicine , cardiology , myocardial infarction , percutaneous coronary intervention , diabetes mellitus , stent , endocrinology
Background Diabetic patients undergoing percutaneous coronary interventions are still regarded as a very high risk category because of an increased platelet reactivity and risk of complications, especially in patients with inadequate glycaemic control. However, although its prognostic effect on long‐term outcome is well‐defined, still unclear is the effect of diabetes on the risk of periprocedural myocardial infarction in patients undergoing percutaneous coronary interventions, which was therefore the aim of our study. Methods Myonecrosis biomarkers were dosed at intervals from 6 to 48 h after nonemergent percutaneous coronary interventions. Periprocedural myocardial infarction was defined as creatine kinase‐MB increase by three times the upper limit normal or by 50% of an elevated baseline value, whereas periprocedural myonecrosis as troponin I increase by three times the upper limit normal or 50% of baseline. Results Of 1311 patients, diabetes mellitus was found in 458 patients (34.9%) and associated with age ( p = 0.03), hypertension ( p < 0.001), renal failure ( p = 0.01), previous MI ( p = 0.03), previous coronary revascularization ( p < 0.001), higher fasting glycaemia and lower haemoglobin ( p < 0.001), more severe coronary disease ( p < 0.001), multivessel percutaneous coronary interventions ( p = 0.03), coronary calcification ( p = 0.003) and in‐stent restenosis ( p < 0.001) but lower presence of thrombus ( p = 0.03). Diabetic patients were receiving significantly more frequent specific pharmacological treatment at admission. Diabetic status did not influence the risk of periprocedural myocardial infarction or periprocedural myonecrosis [adjusted OR(95%CI) = 0.90(0.64–1.27), p = 0.57 and adjusted OR(95%CI) = 0.92(0.70–1.21), p = 0.55]. Amongst diabetic patients, we did not observe any effect of chronic glycaemic control on periprocedural myocardial infarction. Conclusions Diabetic status, independent of chronic glycaemic control, is not associated with increased risk of periprocedural myocardial infarction and myonecrosis in patients undergoing percutaneous coronary interventions. Copyright © 2014 John Wiley & Sons, Ltd.