A Comparison Between Culprit Versus Complete Revascularization in Diabetic Patients With Acute Myocardial Infarction

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2024-11-14 DOI:10.1002/clc.70046

Naser Aslanabadi, Sina Mashayekhi, Maziar Rezvani, Ali Abdollahzadeh, Amirhossein Hajialigol

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引用次数: 0

Abstract

Introduction

The benefit of complete revascularization in diabetic patients with myocardial infarction remains unclear. this study aims to find the optimal strategy of total vascular repair for diabetic patients with acute myocardial infarction.

Methods

In an analysis of a cohort, we assigned diabetic patients with myocardial infarction who were undergoing percutaneous coronary intervention (PCI) of the culprit lesion to receive either staged complete revascularization of nonculprit lesions or to receive no further revascularization in Madani Hospital (Tabriz, Iran). Functionally significant nonculprit lesions were identified either by angiography. The primary outcome was rates of readmission, cardiac deaths, nonfatal myocardial re-infarction, and overall mortality at 1 year.

Results

In our center, a total of 1186 patients underwent primary-PCI treatment, among which 521 were diagnosed with diabetes. Ultimately, 393 patients were selected for inclusion in the study. Within this cohort, 271 individuals (68.9%) underwent repair of only the culprit vessels (group 1), while 122 individuals (31.1%) received a comprehensive staged restoration of the vessels (group 2). During this time, group 1 in comparison with group 2 experienced 204 (75.3%) versus 97 (79.5%) cases of readmission, 48 (17.7%) versus 8 (6.5%) instances of cardiac death, 22 (8.1%) versus 18 (14.7%) occurrences of nonfatal myocardial re-infarction. Notably, the incidence of cardiac death in group 2 were significantly lower than that in group 1 (p ≤ 0.05).

Conclusions

For individuals diagnosed with diabetes, staged complete revascularization demonstrated a lower frequency of readmission, cardiac deaths, nonfatal myocardial reinfarction, and overall mortality, in contrast to revascularization that targeted only the culprit lesion.

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糖尿病急性心肌梗死患者的病因再通术与完全再通术的比较

导言：本研究旨在为急性心肌梗死的糖尿病患者寻找最佳的血管修复策略：在一项队列分析中，我们将在伊朗大不里士市马达尼医院接受经皮冠状动脉介入治疗（PCI）的糖尿病心肌梗死患者分配到接受分阶段非病灶血管完全再通或不再进行血管再通的治疗方案中。通过血管造影术确定功能重要的非病灶。主要结果是再入院率、心脏性死亡、非致命性心肌梗死再发以及1年后的总死亡率：我们中心共有1186名患者接受了初级PCI治疗，其中521人被诊断为糖尿病。最终，393 名患者被选入研究。在这批患者中，271 人（68.9%）只接受了罪魁祸首血管的修复（第 1 组），而 122 人（31.1%）则接受了全面的血管分期修复（第 2 组）。在此期间，第 1 组与第 2 组相比，分别有 204 例（75.3%）和 97 例（79.5%）再次入院，48 例（17.7%）和 8 例（6.5%）心源性死亡，22 例（8.1%）和 18 例（14.7%）非致命性心肌再梗塞。值得注意的是，第 2 组的心源性死亡发生率明显低于第 1 组（P ≤ 0.05）：结论：对于确诊为糖尿病的患者，分阶段完全血运重建术与只针对罪魁祸首病变的血运重建术相比，再入院、心脏病死亡、非致命性心肌再梗死和总死亡率都更低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.