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Non‐ST‐elevation myocardial infarction outcomes in patients with type 2 diabetes with non‐obstructive coronary artery stenosis: Effects of incretin treatment
Author(s) -
Marfella Raffaele,
Sardu Celestino,
Calabrò Paolo,
Siniscalchi Mario,
Minicucci Fabio,
Signoriello Giuseppe,
Balestrieri Maria L.,
Mauro Ciro,
Rizzo Maria R.,
Paolisso Giuseppe,
Barbieri Michelangela
Publication year - 2018
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13122
Subject(s) - medicine , myocardial infarction , cardiology , type 2 diabetes , diabetes mellitus , heart failure , hazard ratio , incretin , acute coronary syndrome , endocrinology , confidence interval
There are insufficient data on the prognosis and management of people with type 2 diabetes who experience a non‐obstructive coronary artery stenosis (NOCS)–non‐ST‐elevation myocardial infarction (NSTEMI) event. We evaluated the 12‐month prognosis of patients with diabetes and NOCS (20%‐49% luminal stenosis) who experience a first NSTEMI as compared with patients without diabetes. In addition, we investigated the 12‐month prognosis in patients with diabetes and NSTEMI‐NOCS previously treated with incretin‐based therapy compared with a matched cohort of patients with NSTEMI‐NOCS never treated with such therapy. We categorized the patients with diabetes as current incretin users (6 months’ treatment with glucagon‐like peptide‐1 agonists or dipeptidyl peptidase‐4 inhibitors) and non‐users of incretins. The endpoint was all‐cause mortality, cardiac death, recurrent acute coronary syndrome (ACS), and heart failure. The unadjusted Kaplan–Meier analysis, and a risk‐adjusted hazard analysis showed that, all‐cause mortality, cardiac death, readmission for ACS and heart failure rates during the 12‐month follow‐up were higher in patients with diabetes and NOCS‐NSTEMI than in those with NOCS‐NSTEMI without diabetes. Among the patients with diabetes, the current incretin users had a significantly lower rate of all‐cause mortality, cardiac death and readmission for ACS at 12 months. In patients with type 2 diabetes and NOCS‐NSTEMI, we observed a higher incidence of 1‐year mortality and adverse cardiovascular outcomes, as compared with patients without diabetes with NOCS‐NSTEMI. In people with diabetes, non‐users of incretins had a worse prognosis than current incretin users.