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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

Nutrition, metabolism, and cardiovascular diseases. 2025 May ; 35 (5) : 103763. [epub] 20241024

Nutr Metab Cardiovasc Dis
ISSN 1590-3729 | 0939-4753
Source

Language English Country Netherlands Media print-electronic

Document type Journal Article, Multicenter Study

Persistent link https://www.medvik.cz/link/pmid39638679

PubMed 39638679
DOI 10.1016/j.numecd.2024.09.031
PII: S0939-4753(24)00382-X
Knihovny.cz E-resources

Keywords
COVID, Diabetes mellitus, PCI, ST-Segment myocardial infarction,
MeSH
Time-to-Treatment MeSH
Time Factors MeSH
COVID-19 * mortality epidemiology MeSH
Diabetes Mellitus * mortality diagnosis epidemiology MeSH
Risk Assessment MeSH
ST Elevation Myocardial Infarction * mortality therapy diagnosis MeSH
Percutaneous Coronary Intervention * mortality adverse effects MeSH
Middle Aged MeSH
Humans MeSH
Hospital Mortality MeSH
Registries MeSH
Retrospective Studies MeSH
Risk Factors MeSH
Aged MeSH
Treatment Outcome MeSH
Check Tag
Middle Aged MeSH
Humans MeSH
Male MeSH
Aged MeSH
Female MeSH
Publication type
Journal Article MeSH
Multicenter Study 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.

Impact of diabetes on epicardial reperfusion and mortality in a contemporary STEMI population undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry

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