Diabetes and Incomplete Revascularisation in ST Elevation Myocardial Infarction

Area of Science:

• Cardiology
• Interventional Cardiology
• Diabetology

Background:

• Incomplete revascularisation (IR) is a known risk factor for adverse cardiac events.
• The combined impact of IR and diabetes on outcomes in ST-elevation myocardial infarction (STEMI) patients remains unclear.

Purpose of the Study:

• To investigate the independent and combined effects of diabetes and IR on long-term cardiac outcomes in STEMI patients treated with percutaneous coronary intervention.

Main Methods:

• Observational study of 589 STEMI patients undergoing percutaneous coronary intervention.
• Incomplete revascularisation defined as a residual SYNTAX Score (rSS) >8.
• Primary endpoint: composite of cardiac death, myocardial infarction, or cerebrovascular accident.

Main Results:

• IR occurred in 36% of diabetic and 32% of non-diabetic STEMI patients.
• The primary endpoint occurred in 35% of patients with both diabetes and IR, versus 14% with neither.
• Patients with both diabetes and IR represented 8% of the cohort but 30% of cardiac deaths.

Conclusions:

• Diabetes and IR are independent predictors of adverse late outcomes in STEMI patients.
• Diabetes exacerbates the negative prognostic impact of IR, suggesting a synergistic effect.
• Achieving complete revascularisation is crucial, especially in diabetic STEMI patients.