Open Access长期临床结局最糟糕的风险因素是什么?韩国高血压与糖尿病患者因急性心肌梗死接受支架置入术后的长期临床结局比较
Author(s) -
Kim Yong Hoon,
Her AeYoung,
Jeong Myung Ho,
Kim ByeongKeuk,
Hong SungJin,
Kim Seunghwan,
Ahn ChulMin,
Kim JungSun,
Ko YoungGuk,
Choi Donghoon,
Hong MyeongKi,
Jang Yangsoo
Publication year - 2020
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.12979
Subject(s) - medicine , hazard ratio , myocardial infarction , cumulative incidence , diabetes mellitus , cardiology , revascularization , retrospective cohort study , proportional hazards model , risk factor , clinical endpoint , confidence interval , cohort , clinical trial , endocrinology
Background Hypertension and diabetes mellitus (DM) are major risk factors for the cardiovascular disease. In this retrospective cohort study, we compared the long‐term clinical outcomes between antecedent hypertension and DM in acute myocardial infarction (AMI) patients after stent implantation. Methods A total of 32 938 eligible AMI patients were enrolled and divided into the four groups according to the presence or absence of hypertension and DM (hypertension −/DM −[group A, 13 773 patients], hypertension +/DM −[group B, 10 395 patients], hypertension −/DM + [group C, 3050 patients], and hypertension +/DM + [group D, 5720 patients]). The clinical endpoint was the cumulative incidence of major adverse cardiac events (MACEs) defined as all‐cause death, recurrent myocardial infarction (Re‐MI) and any repeat revascularization during the 2‐year follow‐up period. Results After adjustment, the cumulative incidence of MACEs (adjusted hazard ratio [aHR], 1.232; 95% confidence interval [CI], 0.982‐1.567; P = .071), all‐cause death, and e‐MI Re‐MI were similar between the group B and C. However, the cumulative incidences of any repeat revascularization (aHR, 1.438; 95% CI, 1.062‐1.997; P = .007), target lesion revascularization (TLR) (aHR, 2.467; 95% CI, 1.552‐3.922; P < .001), and target vessel revascularization (TVR) (aHR, 1.671; 95% CI, 1.256‐2.222; P < .001) were significantly higher in group C compared with group B. Conclusions This large number of a nonrandomized and multicenter cohort study clearly demonstrated the detrimental impacts of the hypertension and diabetes on long‐term clinical outcomes. Moreover, higher incidence of repeat revascularization after PCI in diabetic AMI patients a major concern until recently.