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Impact of diabetes on epicardial reperfusion and mortality in a contemporary STEMI population undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry
G. De Luca, M. Algowhary, B. Uguz, DC. Oliveira, V. Ganyukov, Z. Zimbakov, M. Cercek, LO. Jensen, PH. Loh, L. Calmac, G. Roura I Ferrer, A. Quadros, M. Milewski, FS. D'Uccio, C. von Birgelen, F. Versaci, JT. Berg, G. Casella, AWS. Lung, P. Kala,...
Jazyk angličtina Země Nizozemsko
Typ dokumentu časopisecké články, multicentrická studie
- MeSH
- čas zasáhnout při rozvinutí nemoci MeSH
- časové faktory MeSH
- COVID-19 * mortalita epidemiologie MeSH
- diabetes mellitus * mortalita diagnóza epidemiologie MeSH
- hodnocení rizik MeSH
- infarkt myokardu s elevacemi ST úseků * mortalita terapie diagnóza MeSH
- koronární angioplastika * mortalita škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- mortalita v nemocnicích MeSH
- registrace MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
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.
Azienda Ospedaliero Universitaria Ospedali Riuniti Trieste Italy
Azienda Ospedaliero Universitaria Sassari Italy
Cardiology Division Department of Internal Medicine National Taiwan University Hospital Tapei Taiwan
Cardiology Institute Instanbul University Instanbul Turkey
Carlos E Uribe Division of Cardiology Universidad UPB Universidad CES Medellin Colombia
Center for Cardiovascular Diseases Ohrid Macedonia
Center Hospitalier d'Antibes Juan Les Pins Antibes France
Central Hospital of Medical University of Lodz Poland
Centre for Intensive Internal Medicine University Medical Centre Ljubljana Slovenia
Clinic Emergency Hospital of Bucharest Romania
Complexo Hospetaliero Universitario La Coruna La Coruna Spain
Department of Cardiology Hospital Bezmialem Vakıf University İstanbul Turkey
Department of Cardiology Medisch Spectrum Twente Thoraxcentrum Twente Enschede the Netherlands
Department of Cardiology National Heart Center Singapore
Department of Cardiology National University Hospital Singapore
Department of Cardiology Queen Elizabeth Hospital University of Hong Kong Hong Kong
Department of Cardiology Queen Mary Hospital University of Hong Kong Hong Kong
Department of Cardiology University Hospital Centre University of Zagreb Zagreb Croatia
Department of Internal Medicine Ospedale Riuniti Brescia Italy
Department of Statistical Sciences University of Padova Italy
Department of Teaching and Research Instituto de Cardiología de Corrientes Juana F Cabral Argentina
Division of Cardiology Alexandra Hospital Athens Greece
Division of Cardiology Assiut University Heart Hospital Assiut University Asyut Egypt
Division of Cardiology Attikon University Hospital Athens Greece
Division of Cardiology AUSL IRCCS Reggio Emilia Italy
Division of Cardiology Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
Division of cardiology Blida University Hospital Blida Algeria
Division of Cardiology Bursa City Hospital Bursa Turkey
Division of Cardiology Center Hospitalier Universitaire de Lille Lille France
Division of Cardiology CHU Lariboisière AP HP Paris 7 University INSERM UMRS 942 France
Division of Cardiology Clinica Villa dei Fiori Acerra Italy
Division of Cardiology Complejo Hospitalario de Toledo Toledo Spain
Division of Cardiology Eskisehir Osmangazi University Faculty of Medicine Eskisehir Turkey
Division of Cardiology Groupe Hospitalier Mutualiste de Grenoble France
Division of Cardiology Heart Centre Turku Finland
Division of Cardiology Hopital Erasmus Universitè Libre de Bruxelles Belgium
Division of Cardiology Hospiatl Cordoba Cordoba Argentina
Division of Cardiology Hospital Cabueñes Gijon Spain
Division of Cardiology Hospital Clinico Universitario de Valencia Spain
Division of Cardiology Hospital de Santa Cruz CHLO Nova Medical School CEDOC Lisbon Portugal
Division of Cardiology Hospital de Santo António Porto Portugal
Division of Cardiology Hospital Puerta de Hierro Majadahonda Spain
Division of Cardiology Hospital Puerta del Mar Cadiz Spain
Division of cardiology Hospital Universitario de Canarias Santa Cruz de Tenerife Spain
Division of Cardiology IRCSS Galeazzi Sant'Ambrogio Hospital Milan Italy
Division of Cardiology Kontantopoulion Hospital Athens Greece
Division of Cardiology Medical University of Silezia Katowice Poland
Division of Cardiology Northwest Clinics Alkmaar the Netherlands
Division of Cardiology Odense Universitets Hospital Odense Denmark
Division of Cardiology Ospedale A Manzoni Lecco Italy
Division of Cardiology Ospedale Civico Arnas Palermo Italy
Division of Cardiology Ospedale degli Infermi ASL Biella Italy
Division of Cardiology Ospedale del Mare Napoli Italy
Division of Cardiology Ospedale F Spaziani Frosinone Italy
Division of Cardiology Ospedale G Moscati Aversa Italy
Division of Cardiology Ospedale Maggiore Bologna Italy
Division of Cardiology Ospedale S Maurizio Bolzano Italy
Division of Cardiology Ospedale San Giovanni di Dio e Ruggi d'Aragona Salerno Italy
Division of Cardiology Ospedale Sant'Anna Ferrara Italy
Division of Cardiology Ospedale Santa Chiara di Trento Italy
Division of Cardiology Ospedale Santa Maria Goretti Latina Italy
Division of Cardiology Otamendi Hospital Buenos Aires Argentina
Division of Cardiology Oulu University Hospital Finland
Division of Cardiology Radboud University Medical Center Nijmegen the Netherlands
Division of Cardiology St Antonius Hospital Nieuwegein the Netherlands
Division of Cardiology UMC Utrecht the Netherlands
H Universitario y Politécnico La Fe Valencia Spain
Hospital Clínico Universitario Virgen de la Victoria Málaga Spain
Hospital Garcia de Orta Cardiology Department Pragal Almada Portugal
Hospital Germans Triasi Pujol Badalona Spain
Instituto Cardiovascular de Buenos Aires Buenos Aires Argentina
Instituto de Cardiologia de Santa Catarina Praia Comprida São José Brazil
Instituto de Cardiologia do Rio Grande do Sul Porto Alegre Brazil
Instituto de Cardiologia Integral Montevideo Uruguay
Interventional Cardiolgy Unit IRCCS INRCA Ancona Italy
Interventional Cardiology Unit Azienda Ospedaliera Sanitaria Parma Italy
Interventional Cardiology Unit Heart Disease Institute Hospital Universitari de Bellvitge Spain
Invasive Cardiology and Congenital Heart Disease Patras University Hospital Patras Greece
Iraklion University Hospital Crete Greece
Maastricht University Medical Center the Netherlands
Tyumen Cardiology Research Center Russia
University Clinic for Cardiology Medical Faculty Ss' Cyril and Methodius University Skopje Macedonia
University Hospital Brno Medical Faculty of Masaryk University Brno Czech Republic
Citace poskytuje Crossref.org
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- $a De Luca, Giuseppe $u Division of Cardiology, AOU "Policlinico G. Martino", Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; Division of Cardiology, IRCSS Galeazzi-Sant'Ambrogio Hospital, Milan, Italy. Electronic address: giuseppe.deluca@unime.it
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- $a Impact of diabetes on epicardial reperfusion and mortality in a contemporary STEMI population undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry / $c G. De Luca, M. Algowhary, B. Uguz, DC. Oliveira, V. Ganyukov, Z. Zimbakov, M. Cercek, LO. Jensen, PH. Loh, L. Calmac, G. Roura I Ferrer, A. Quadros, M. Milewski, FS. D'Uccio, C. von Birgelen, F. Versaci, JT. Berg, G. Casella, AWS. Lung, P. Kala, JL. Díez Gil, X. Carrillo, M. Dirksen, VM. Becerra-Munoz, MK. Lee, DA. Juzar, R. Moura Joaquim, R. Paladino, D. Milicic, P. Davlouros, N. Bakraceski, F. Zilio, L. Donazzan, A. Kraaijeveld, G. Galasso, L. Arpad, M. Lucia, G. Vincenzo, M. Menichelli, A. Scoccia, AH. Yamac, KU. Mert, XF. Rios, T. Kovarnik, M. Kidawa, J. Moreu, V. Flavien, E. Fabris, IL. Martínez-Luengas, FB. Ojeda, R. Rodríguez-Sanchez, G. Caiazzo, G. Cirrincione, HL. Kao, JS. Forés, L. Vignali, H. Pereira, S. Manzo, S. Ordoñez, AA. Özkan, B. Scheller, H. Lehtola, R. Teles, C. Mantis, Y. Antti, JAB. Silveira, R. Zoni, I. Bessonov, S. Savonitto, G. Kochiadakis, D. Alexopulos, CE. Uribe, J. Kanakakis, B. Faurie, G. Gabrielli, A. Gutierrez Barrios, JP. Bachini, A. Rocha, FC. Tam, A. Rodriguez, AA. Lukito, A. Bellemain-Appaix, G. Pessah, G. Cortese, G. Parodi, MA. Burgadha, E. Kedhi, P. Lamelas, H. Suryapranata, M. Nardin, M. Verdoia
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- $a 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.
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