Aim

We compared the 2-year clinical outcomes between prediabetes and type 2 diabetes mellitus (T2DM) in patients with acute myocardial infarction (AMI) and chronic kidney disease (CKD) after the successful implantation of new-generation drug-eluting stents.

Methods

A total of 11,961 AMI patients were classified into group A (estimated glomerular filtration rate [eGFR] < 60 ml/min/1.73m², n = 2271) and group B (eGFR ≥60 ml/min/1.73 m², n = 9690). These two groups were sub-classified into normoglycemia, prediabetes, and T2DM. The occurrence of major adverse cardiac events (MACE), defined as all-cause death, recurrent MI (re-MI), and any repeat revascularization was evaluated.

Results

In group A, the MACE (p = 0.016 and p = 0.004, respectively) and all-cause death (p = 0.044, and p = 0.031, respectively) rates; in groups B, the MACE, all-cause death, and cardiac death rates, were significantly higher in the prediabetes and T2DM groups than in the normoglycemia group. The re-MI and any repeat revascularization rates were significantly higher in the T2DM group than in the normoglycemia group. The MACE, all-cause death, and cardiac death rates in group A were significantly higher than those in all three glycemic subgroups of group B. Both in group A and B, the major clinical outcomes were not significantly different between the prediabetes and T2DM groups.

Conclusions

AMI patients, both with prediabetes and T2DM, showed a higher mortality rate than those with normoglycemia regardless of the degree of eGFR.

中文翻译：

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新一代药物洗脱支架置入后急性心肌梗死患者血糖状态和肾功能两年临床结果的比较

目标

我们比较了新一代药物洗脱支架成功植入后急性心肌梗死 (AMI) 和慢性肾病 (CKD) 患者糖尿病前期和 2 型糖尿病 (T2DM) 的 2 年临床结果。

方法

共有 11,961 名 AMI 患者被分为 A 组（估计肾小球滤过率 [eGFR] < 60 ml/min/1.73m ²，n = 2271）和 B 组（eGFR ≥60 ml/min/1.73 m ²，n = 9690）。这两组被细分为血糖正常、糖尿病前期和 T2DM。评估了主要不良心脏事件 (MACE) 的发生，定义为全因死亡、复发性心肌梗死 (re-MI) 和任何重复血运重建。

结果

在 A 组中，MACE（分别为p  = 0.016 和p  = 0.004）和全因死亡（分别为p  = 0.044 和p  = 0.031）率；在 B 组中，前驱糖尿病组和 T2DM 组的 MACE、全因死亡率和心源性死亡率显着高于血糖正常组。T2DM 组的再次 MI 和任何重复血运重建率显着高于正常血糖组。A组的MACE、全因死亡率和心源性死亡率均显着高于B组所有三个血糖亚组。在A组和B组中，前驱糖尿病组和T2DM组的主要临床结局均无显着差异.

结论

无论 eGFR 的程度如何，患有糖尿病前期和 T2DM 的 AMI 患者的死亡率都高于血糖正常的患者。