TY - JOUR
T1 - Impact of diabetes on epicardial reperfusion and mortality in a contemporary STEMI population undergoing mechanical reperfusion
T2 - Insights from the ISACS STEMI COVID 19 registry
AU - De Luca, Giuseppe
AU - Algowhary, Magdy
AU - Uguz, Berat
AU - Oliveira, Dinaldo C.
AU - Ganyukov, Vladimir
AU - Zimbakov, Zan
AU - Cercek, Miha
AU - Jensen, Lisette Okkels
AU - Loh, Poay Huan
AU - Calmac, Lucian
AU - Roura i Ferrer, Gerard
AU - Quadros, Alexandre
AU - Milewski, Marek
AU - D'Uccio, Fortunato Scotto
AU - von Birgelen, Clemens
AU - Versaci, Francesco
AU - Berg, Jurrien Ten
AU - Casella, Gianni
AU - Lung, Aaron Wong Sung
AU - Kala, Petr
AU - Díez Gil, José Luis
AU - Carrillo, Xavier
AU - Dirksen, Maurits
AU - Becerra-Munoz, Victor M.
AU - Lee, Michael Kang yin
AU - Juzar, Dafsah Arifa
AU - Moura Joaquim, Rodrigo de
AU - Paladino, Roberto
AU - Milicic, Davor
AU - Davlouros, Periklis
AU - Bakraceski, Nikola
AU - Zilio, Filippo
AU - Donazzan, Luca
AU - Kraaijeveld, Adriaan
AU - Galasso, Gennaro
AU - Arpad, Lux
AU - Lucia, Marinucci
AU - Vincenzo, Guiducci
AU - Menichelli, Maurizio
AU - Scoccia, Alessandra
AU - Yamac, Aylin Hatice
AU - Mert, Kadir Ugur
AU - Rios, Xacobe Flores
AU - Kovarnik, Tomas
AU - Kidawa, Michal
AU - Moreu, Josè
AU - Flavien, Vincent
AU - Fabris, Enrico
AU - Martínez-Luengas, Iñigo Lozano
AU - Ojeda, Francisco Bosa
AU - Rodríguez-Sanchez, Robert
AU - Caiazzo, Gianluca
AU - Cirrincione, Giuseppe
AU - Kao, Hsien Li
AU - Forés, Juan Sanchis
AU - Vignali, Luigi
AU - Pereira, Helder
AU - Manzo, Stephane
AU - Ordoñez, Santiago
AU - Özkan, Alev Arat
AU - Scheller, Bruno
AU - Lehtola, Heidi
AU - Teles, Rui
AU - Mantis, Christos
AU - Antti, Ylitalo
AU - Silveira, João António Brum
AU - Zoni, Rodrigo
AU - Bessonov, Ivan
AU - Savonitto, Stefano
AU - Kochiadakis, George
AU - Alexopulos, Dimitrios
AU - Uribe, Carlos E.
AU - Kanakakis, John
AU - Faurie, Benjamin
AU - Gabrielli, Gabriele
AU - Gutierrez Barrios, Alejandro
AU - Bachini, Juan Pablo
AU - Rocha, Alex
AU - Tam, Frankie Chor Cheung
AU - Rodriguez, Alfredo
AU - Lukito, Antonia Anna
AU - Bellemain-Appaix, Anne
AU - Pessah, Gustavo
AU - Cortese, Giuliana
AU - Parodi, Guido
AU - Burgadha, Mohammed Abed
AU - Kedhi, Elvin
AU - Lamelas, Pablo
AU - Suryapranata, Harry
AU - Nardin, Matteo
AU - Verdoia, Monica
PY - 2025/5
Y1 - 2025/5
N2 - 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.
AB - 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.
KW - COVID
KW - Diabetes mellitus
KW - PCI
KW - ST-Segment myocardial infarction
KW - ST Elevation Myocardial Infarction/mortality
KW - Hospital Mortality
KW - Time-to-Treatment
KW - Risk Assessment
KW - Humans
KW - Middle Aged
KW - Risk Factors
KW - Male
KW - Treatment Outcome
KW - COVID-19/mortality
KW - Percutaneous Coronary Intervention/mortality
KW - Diabetes Mellitus/mortality
KW - Time Factors
KW - Female
KW - Registries
KW - Aged
KW - Retrospective Studies
U2 - 10.1016/j.numecd.2024.09.031
DO - 10.1016/j.numecd.2024.09.031
M3 - Journal article
C2 - 39638679
AN - SCOPUS:85211020372
SN - 0939-4753
VL - 35
JO - Nutrition, Metabolism and Cardiovascular Diseases
JF - Nutrition, Metabolism and Cardiovascular Diseases
IS - 5
M1 - 103763
ER -