Related Experiment Video
Updated: Aug 21, 2026
Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
Primary coronary angioplasty in patients with ST segment elevation acute myocardial infarction and diabetes
Dariusz Dudek1, Waldemar Mielecki, Marcin Wizimirski
1Department of Hemodynamics and Angiocardiography, Institute of Cardiology, Jagiellonian University, College of Medicine, Cracow, Poland.
Insights
Patients with diabetes undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) experience lower reperfusion rates and a nearly doubled risk of major adverse cardiac events (MACE) within six months.
Area of Science:
- Cardiology
- Diabetology
- Interventional Cardiology
Background:
- Diabetes is prevalent in ST-elevation myocardial infarction (STEMI) patients, associated with poorer outcomes despite reperfusion therapies.
- Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for STEMI.
Purpose of the Study:
- To compare the outcomes of STEMI patients with and without diabetes who underwent primary PCI.
Main Methods:
- A study of 500 STEMI patients undergoing primary PCI.
- Analysis of major adverse cardiac events (MACE) including death, reinfarction, and repeat PCI during peri-operative and six-month follow-up periods.
- Comparison of reperfusion rates and clinical outcomes between diabetic and non-diabetic patient groups.
Main Results:
- Diabetic STEMI patients (13.6%) were older with more comorbidities.
- Lower epicardial and myocardial reperfusion rates were observed in diabetic patients post-PCI.
- Diabetes significantly increased in-hospital MACE risk (2.7 times) and nearly doubled six-month MACE risk.
Conclusions:
- Primary PCI in STEMI patients with diabetes results in suboptimal reperfusion.
- Diabetes is an independent risk factor for adverse cardiac events following primary PCI for STEMI.
Background:
Subjects with diabetes constitute 13-25% of patients with ST segment elevation acute myocardial infarction (STEMI). In spite of the introduction of thrombolytic therapy, patients with STEMI and diabetes continue to have worse prognosis than those without diabetes. Primary percutaneous coronary intervention (PCI) has been shown in recent years to be the most effective therapy in patients with STEMI.
Aim:
To compare the outcome of STEMI patients with or without diabetes who underwent primary PCI.
Methods:
The study group consisted of 500 consecutive patients with STEMI. The occurrence of major adverse cardiac events (MACE) which included death, reinfarction or repeated PCI of the target vessel, was analysed peri-operatively and during a six-month follow-up period.Results. Diabetes was diagnosed in 68 (13.6%) patients. The mean time duration from the onset of STEMI symptoms to treatment was similar in patients with or without diabetes (230+/-97 min vs 231+/-139 min, NS). Patients with diabetes were older (61.9+/-8.9 vs 57.9+/-10.8 years, p=0.004), had higher body mass index (29+/-4 vs 27+/-5, p=0.002), more frequent history of coronary artery disease (57.4% vs 37.9%, p=0.002), higher prevalence of arterial hypertension (71.6% vs 56.8%, p=0.02) and more frequently the left anterior descending artery as the infarct-related artery (58.8% vs 42.1%, p=0.01). Immediately after PCI, epicardial and myocardial reperfusion rates were lower in patients with rather than without diabetes (TIMI 3: 84.9% vs 91.3%, p=NS, cTFC: 32+/-26 vs 22+/-16, p<0.0001, and MPG3: 25% vs 41.9% p=0.008). Diabetes increased the risk of MACE during in-hospital period by 2.7 times. The rate of MACE during a six-month follow-up period was almost two times higher in patients with rather than without diabetes (death: 8.8% vs 5.1%, reinfarction: 1.5% vs 1.2%, repeated PCI: 11.8% vs 6.9%).
Conclusions:
Primary PCI-achieved epicardial and myocardial reperfusion rate is lower in STEMI patients with rather than without diabetes. The presence of diabetes almost doubles the risk of MACE during a six-month follow-up.
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Peripheral Artery Disease III: Interprofessional Care