Conflict of interest: No authors have relevant conflicts of interest to declare with the exceptions of Dr. Roxana Mehran who reports serving as consultant for Cardiva, Cordis, The Medicines Company, Regado Biosciences, and receiving research grant support from Bristol-Myers Squibb/Sanofi-Aventis, Dr. C. Michael Gibson who received research grant support from Atrium Medical, and Dr. Gregg W. Stone who reports serving on the advisory boards for and receiving honoraria from Boston Scientific and Abbott Vascular.
Coronary Artery Disease
Outcomes in diabetic patients undergoing primary percutaneous coronary intervention for acute anterior myocardial infarction: Results from the INFUSE-AMI study
Article first published online: 23 OCT 2013
Copyright © 2013 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 83, Issue 5, pages 704–710, 1 April 2014
How to Cite
Sanidas, E. A., Brener, S. J., Maehara, A., Généreux, P., Witzenbichler, B., El-Omar, M., Fahy, M., Mehran, R., Gibson, C. M. and Stone, G. W. (2014), Outcomes in diabetic patients undergoing primary percutaneous coronary intervention for acute anterior myocardial infarction: Results from the INFUSE-AMI study. Cathet. Cardiovasc. Intervent., 83: 704–710. doi: 10.1002/ccd.25203
- Issue published online: 18 MAR 2014
- Article first published online: 23 OCT 2013
- Accepted manuscript online: 13 SEP 2013 03:28AM EST
- Manuscript Accepted: 8 SEP 2013
- Manuscript Revised: 24 JUL 2013
- Manuscript Received: 14 JUN 2013
- diabetes mellitus;
- myocardial infarction;
- infarct size;
- primary PCI
To evaluate the clinical, angiographic, and cardiac magnetic resonance imaging (cMRI) results in patients with and without diabetes mellitus (DM) undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI).
DM has been associated with increased mortality in patients with STEMI, yet the mechanisms underpinning this association have not been completely elucidated.
Overall, 451 patients (51 diabetics) from the INFUSE-AMI trial were studied. They presented with an anterior STEMI due to an occluded left anterior descending artery (LAD) and underwent bivalirudin-supported primary PCI with or without intralesion abciximab and with or without thrombus aspiration. Angiographic baseline and post-procedure parameters, cMRI at 30 days, and clinical follow-up at 30 days and at 1 year were compared between diabetic and nondiabetic patients.
Patients with DM had significantly more comorbidities and more extensive LAD disease than nondiabetics. Primary PCI was equally effective in restoring coronary flow in both groups and the infarct size at 30 days was similar (14.3% [7.1, 24.5] vs. 17.3% [8.1, 23.6], respectively, P = 0.55). Diabetic patients had more major cardiovascular and cerebrovascular events at 1 year (16.5% vs. 8.0%, P = 0.04). Stent thrombosis within 30 days after primary PCI was higher in diabetic than in nondiabetic subjects (4.3% vs. 0.8%, P = 0.03).
Patients with DM presenting with STEMI had a higher baseline risk profile than those without DM. Although reperfusion success and infarct size were similar, diabetic patients experienced more death, reinfarction, stent thrombosis, and revascularization than nondiabetics. © 2013 Wiley Periodicals, Inc.