Sex-specific outcomes of diabetic patients with acute myocardial infarction who have undergone percutaneous coronary intervention: a register linkage study
<p>Abstract</p> <p>Background</p> <p>The presence of diabetes mellitus poses a challenge in the treatment of patients with acute myocardial infarction (AMI). We aimed to evaluate the sex-specific outcomes of diabetic and non-diabetic patients with AMI who have undergone...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-08-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | http://www.cardiab.com/content/11/1/96 |
| _version_ | 1830440228533305344 |
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| author | Blöndal Mai Ainla Tiia Marandi Toomas Baburin Aleksei Eha Jaan |
| author_facet | Blöndal Mai Ainla Tiia Marandi Toomas Baburin Aleksei Eha Jaan |
| author_sort | Blöndal Mai |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The presence of diabetes mellitus poses a challenge in the treatment of patients with acute myocardial infarction (AMI). We aimed to evaluate the sex-specific outcomes of diabetic and non-diabetic patients with AMI who have undergone percutaneous coronary intervention (PCI).</p> <p>Methods</p> <p>Data of the Estonian Myocardial Infarction Registry for years 2006–2009 were linked with the Health Insurance Fund database and the Population Registry. Hazard ratios (HRs) with the 95% confidence intervals (CIs) for the primary composite outcome (non-fatal AMI, revascularization, or death whichever occurred first) and for the secondary outcome (all cause mortality) were calculated comparing diabetic with non-diabetic patients by sex.</p> <p>Results</p> <p>In the final study population (n = 1652), 14.6% of the men and 24.0% of the women had diabetes. Overall, the diabetics had higher rates of cardiovascular risk factors, co-morbidities, and 3–4 vessel disease among both men and women (p < 0.01). Among women, the diabetic patients were younger, they presented later and less often with typical symptoms of chest pain than the non-diabetics (p < 0.01). Women with diabetes received aspirin and reperfusion for ST-segment elevation AMI less often than those without diabetes (p < 0.01). During a follow-up of over two years, in multivariate analysis, diabetes was associated with worse outcomes only in women: the adjusted HR for the primary outcome 1.44 (95% CI 1.05 − 1.96) and for the secondary outcome 1.83 (95% CI 1.17 − 2.89). These results were largely driven by a high (12.0%) mortality during hospitalization of diabetic women.</p> <p>Conclusions</p> <p>Diabetic women with AMI who have undergone PCI are a high-risk group warranting special attention in treatment strategies, especially during hospitalization. There is a need to improve the expertise to detect AMI earlier, decrease disparities in management, and find targeted PCI strategies with adjunctive antithrombotic regimes in women with diabetes.</p> |
| first_indexed | 2024-12-21T04:58:08Z |
| format | Article |
| id | doaj.art-61128db9e9594b478b9cdf16064916f7 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-21T04:58:08Z |
| publishDate | 2012-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-61128db9e9594b478b9cdf16064916f72022-12-21T19:15:18ZengBMCCardiovascular Diabetology1475-28402012-08-011119610.1186/1475-2840-11-96Sex-specific outcomes of diabetic patients with acute myocardial infarction who have undergone percutaneous coronary intervention: a register linkage studyBlöndal MaiAinla TiiaMarandi ToomasBaburin AlekseiEha Jaan<p>Abstract</p> <p>Background</p> <p>The presence of diabetes mellitus poses a challenge in the treatment of patients with acute myocardial infarction (AMI). We aimed to evaluate the sex-specific outcomes of diabetic and non-diabetic patients with AMI who have undergone percutaneous coronary intervention (PCI).</p> <p>Methods</p> <p>Data of the Estonian Myocardial Infarction Registry for years 2006–2009 were linked with the Health Insurance Fund database and the Population Registry. Hazard ratios (HRs) with the 95% confidence intervals (CIs) for the primary composite outcome (non-fatal AMI, revascularization, or death whichever occurred first) and for the secondary outcome (all cause mortality) were calculated comparing diabetic with non-diabetic patients by sex.</p> <p>Results</p> <p>In the final study population (n = 1652), 14.6% of the men and 24.0% of the women had diabetes. Overall, the diabetics had higher rates of cardiovascular risk factors, co-morbidities, and 3–4 vessel disease among both men and women (p < 0.01). Among women, the diabetic patients were younger, they presented later and less often with typical symptoms of chest pain than the non-diabetics (p < 0.01). Women with diabetes received aspirin and reperfusion for ST-segment elevation AMI less often than those without diabetes (p < 0.01). During a follow-up of over two years, in multivariate analysis, diabetes was associated with worse outcomes only in women: the adjusted HR for the primary outcome 1.44 (95% CI 1.05 − 1.96) and for the secondary outcome 1.83 (95% CI 1.17 − 2.89). These results were largely driven by a high (12.0%) mortality during hospitalization of diabetic women.</p> <p>Conclusions</p> <p>Diabetic women with AMI who have undergone PCI are a high-risk group warranting special attention in treatment strategies, especially during hospitalization. There is a need to improve the expertise to detect AMI earlier, decrease disparities in management, and find targeted PCI strategies with adjunctive antithrombotic regimes in women with diabetes.</p>http://www.cardiab.com/content/11/1/96Diabetes mellitusSexAcute myocardial infarctionPercutaneous coronary interventionMortalityOutcome |
| spellingShingle | Blöndal Mai Ainla Tiia Marandi Toomas Baburin Aleksei Eha Jaan Sex-specific outcomes of diabetic patients with acute myocardial infarction who have undergone percutaneous coronary intervention: a register linkage study Cardiovascular Diabetology Diabetes mellitus Sex Acute myocardial infarction Percutaneous coronary intervention Mortality Outcome |
| title | Sex-specific outcomes of diabetic patients with acute myocardial infarction who have undergone percutaneous coronary intervention: a register linkage study |
| title_full | Sex-specific outcomes of diabetic patients with acute myocardial infarction who have undergone percutaneous coronary intervention: a register linkage study |
| title_fullStr | Sex-specific outcomes of diabetic patients with acute myocardial infarction who have undergone percutaneous coronary intervention: a register linkage study |
| title_full_unstemmed | Sex-specific outcomes of diabetic patients with acute myocardial infarction who have undergone percutaneous coronary intervention: a register linkage study |
| title_short | Sex-specific outcomes of diabetic patients with acute myocardial infarction who have undergone percutaneous coronary intervention: a register linkage study |
| title_sort | sex specific outcomes of diabetic patients with acute myocardial infarction who have undergone percutaneous coronary intervention a register linkage study |
| topic | Diabetes mellitus Sex Acute myocardial infarction Percutaneous coronary intervention Mortality Outcome |
| url | http://www.cardiab.com/content/11/1/96 |
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