Philipp Jakob, Ferdinando Varbella, Axel Linke, Bettina Schwarz, Stephan B Felix, Moritz Seiffert, Rahel Kesterke, Peter Nordbeck, Bernhard Witzenbichler, Irene M Lang, Mirjam Kessler, Christian Valina, Alban Dibra, Miklos Rohla, Marco Moccetti, Matteo Vercellino, Luise Gaede, Lorenz Bott-Flügel, Julia Stehli, Alessandro Candreva, Francesco Paneni, Christian Templin, Matthias Schindler, Manfred Wischnewsky, Greca Zanda, Giorgio Quadri, Norman Mangner, Aurel Toma, Giulia Magnani, Peter Clemmensen, Thomas F Lüscher, Thomas Münzel, P Christian Schulze, Karl-Ludwig Laugwitz, Wolfgang Rottbauer, Kurt Huber, Franz-Josef Neumann, Steffen Schneider, Thomas Riemer, Franz Weidinger, Stephan Achenbach, Gert Richardt, Adnan Kastrati, Ian Ford, Frank Ruschitzka, Barbara E Stähli
{"title":"糖尿病对st段抬高型心肌梗死合并多支冠状动脉疾病患者经皮冠状动脉介入治疗预后的影响","authors":"Philipp Jakob, Ferdinando Varbella, Axel Linke, Bettina Schwarz, Stephan B Felix, Moritz Seiffert, Rahel Kesterke, Peter Nordbeck, Bernhard Witzenbichler, Irene M Lang, Mirjam Kessler, Christian Valina, Alban Dibra, Miklos Rohla, Marco Moccetti, Matteo Vercellino, Luise Gaede, Lorenz Bott-Flügel, Julia Stehli, Alessandro Candreva, Francesco Paneni, Christian Templin, Matthias Schindler, Manfred Wischnewsky, Greca Zanda, Giorgio Quadri, Norman Mangner, Aurel Toma, Giulia Magnani, Peter Clemmensen, Thomas F Lüscher, Thomas Münzel, P Christian Schulze, Karl-Ludwig Laugwitz, Wolfgang Rottbauer, Kurt Huber, Franz-Josef Neumann, Steffen Schneider, Thomas Riemer, Franz Weidinger, Stephan Achenbach, Gert Richardt, Adnan Kastrati, Ian Ford, Frank Ruschitzka, Barbara E Stähli","doi":"10.1007/s00392-025-02745-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Diabetic patients with ST-segment elevation myocardial infarction (STEMI) are at an increased risk of cardiovascular events as compared to non-diabetic patients. This analysis investigated outcomes of diabetic patients presenting with multivessel disease (MVD) and STEMI in a contemporary trial and the relevance of an immediate versus staged multivessel PCI strategy in this high-risk population.</p><p><strong>Methods: </strong>Patients enrolled in the MULTISTARS AMI trial were stratified according to the presence/absence of diabetes. Baseline characteristics and outcomes of diabetic and non-diabetic patients were compared. The primary end point was a composite of all-cause death, non-fatal myocardial infarction, stroke, unplanned ischemia-driven revascularization, or hospitalization for heart failure at 1 year.</p><p><strong>Results: </strong>In the MULTISTARS AMI trial, out of a total of 840 patients, 131 (15.6%) patients had diabetes. Patients with diabetes had a higher cardiovascular risk profile and worse kidney function. The occurrence of the primary end point was similar between patients with and without diabetes (HR, 1.14 (95% CI, 0.69-1.90), p-value = 0.60). Rates of non-cardiovascular death (HR, 6.53 (95% CI, 2.00-21.33)) and acute renal failure (HR, 3.23 (95% CI, 1.49-7.04)) were higher in diabetic patients as compared to non-diabetic patients. Comparing an immediate with a staged PCI strategy in diabetic patients, a numerically lower number of patients in the immediate PCI group experienced a primary end point event (10.6% vs. 16.9%, HR, 0.60 (95% CI, 0.23-1.53), p-value = 0.28).</p><p><strong>Conclusion: </strong>Among diabetic patients with STEMI and MVD, a strategy of immediate multivessel PCI may be safe and comparable to a strategy of staged multivessel PCI.</p><p><strong>Trial registration: </strong>Supported by Boston Scientific; MULTISTARS AMI ClinicalTrials.gov number, NCT03135275.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of diabetes on outcomes of patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease undergoing percutaneous coronary intervention.\",\"authors\":\"Philipp Jakob, Ferdinando Varbella, Axel Linke, Bettina Schwarz, Stephan B Felix, Moritz Seiffert, Rahel Kesterke, Peter Nordbeck, Bernhard Witzenbichler, Irene M Lang, Mirjam Kessler, Christian Valina, Alban Dibra, Miklos Rohla, Marco Moccetti, Matteo Vercellino, Luise Gaede, Lorenz Bott-Flügel, Julia Stehli, Alessandro Candreva, Francesco Paneni, Christian Templin, Matthias Schindler, Manfred Wischnewsky, Greca Zanda, Giorgio Quadri, Norman Mangner, Aurel Toma, Giulia Magnani, Peter Clemmensen, Thomas F Lüscher, Thomas Münzel, P Christian Schulze, Karl-Ludwig Laugwitz, Wolfgang Rottbauer, Kurt Huber, Franz-Josef Neumann, Steffen Schneider, Thomas Riemer, Franz Weidinger, Stephan Achenbach, Gert Richardt, Adnan Kastrati, Ian Ford, Frank Ruschitzka, Barbara E Stähli\",\"doi\":\"10.1007/s00392-025-02745-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Diabetic patients with ST-segment elevation myocardial infarction (STEMI) are at an increased risk of cardiovascular events as compared to non-diabetic patients. This analysis investigated outcomes of diabetic patients presenting with multivessel disease (MVD) and STEMI in a contemporary trial and the relevance of an immediate versus staged multivessel PCI strategy in this high-risk population.</p><p><strong>Methods: </strong>Patients enrolled in the MULTISTARS AMI trial were stratified according to the presence/absence of diabetes. Baseline characteristics and outcomes of diabetic and non-diabetic patients were compared. The primary end point was a composite of all-cause death, non-fatal myocardial infarction, stroke, unplanned ischemia-driven revascularization, or hospitalization for heart failure at 1 year.</p><p><strong>Results: </strong>In the MULTISTARS AMI trial, out of a total of 840 patients, 131 (15.6%) patients had diabetes. Patients with diabetes had a higher cardiovascular risk profile and worse kidney function. The occurrence of the primary end point was similar between patients with and without diabetes (HR, 1.14 (95% CI, 0.69-1.90), p-value = 0.60). Rates of non-cardiovascular death (HR, 6.53 (95% CI, 2.00-21.33)) and acute renal failure (HR, 3.23 (95% CI, 1.49-7.04)) were higher in diabetic patients as compared to non-diabetic patients. Comparing an immediate with a staged PCI strategy in diabetic patients, a numerically lower number of patients in the immediate PCI group experienced a primary end point event (10.6% vs. 16.9%, HR, 0.60 (95% CI, 0.23-1.53), p-value = 0.28).</p><p><strong>Conclusion: </strong>Among diabetic patients with STEMI and MVD, a strategy of immediate multivessel PCI may be safe and comparable to a strategy of staged multivessel PCI.</p><p><strong>Trial registration: </strong>Supported by Boston Scientific; MULTISTARS AMI ClinicalTrials.gov number, NCT03135275.</p>\",\"PeriodicalId\":10474,\"journal\":{\"name\":\"Clinical Research in Cardiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Research in Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00392-025-02745-x\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Research in Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00392-025-02745-x","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Impact of diabetes on outcomes of patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease undergoing percutaneous coronary intervention.
Background: Diabetic patients with ST-segment elevation myocardial infarction (STEMI) are at an increased risk of cardiovascular events as compared to non-diabetic patients. This analysis investigated outcomes of diabetic patients presenting with multivessel disease (MVD) and STEMI in a contemporary trial and the relevance of an immediate versus staged multivessel PCI strategy in this high-risk population.
Methods: Patients enrolled in the MULTISTARS AMI trial were stratified according to the presence/absence of diabetes. Baseline characteristics and outcomes of diabetic and non-diabetic patients were compared. The primary end point was a composite of all-cause death, non-fatal myocardial infarction, stroke, unplanned ischemia-driven revascularization, or hospitalization for heart failure at 1 year.
Results: In the MULTISTARS AMI trial, out of a total of 840 patients, 131 (15.6%) patients had diabetes. Patients with diabetes had a higher cardiovascular risk profile and worse kidney function. The occurrence of the primary end point was similar between patients with and without diabetes (HR, 1.14 (95% CI, 0.69-1.90), p-value = 0.60). Rates of non-cardiovascular death (HR, 6.53 (95% CI, 2.00-21.33)) and acute renal failure (HR, 3.23 (95% CI, 1.49-7.04)) were higher in diabetic patients as compared to non-diabetic patients. Comparing an immediate with a staged PCI strategy in diabetic patients, a numerically lower number of patients in the immediate PCI group experienced a primary end point event (10.6% vs. 16.9%, HR, 0.60 (95% CI, 0.23-1.53), p-value = 0.28).
Conclusion: Among diabetic patients with STEMI and MVD, a strategy of immediate multivessel PCI may be safe and comparable to a strategy of staged multivessel PCI.
Trial registration: Supported by Boston Scientific; MULTISTARS AMI ClinicalTrials.gov number, NCT03135275.
期刊介绍：
Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery.
As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
