Effect of Diabetes Mellitus and Left Ventricular Perfusion on Frequency of Development of Heart Failure and/or All-cause Mortality Late After Acute Myocardial Infarction.

Affiliation

Tomasik A(1), Nabrdalik K(2), Kwiendacz H(3), Radzik E(1), Pigoń K(1), Młyńczak T(1), Sawczyn T(4), Gumprecht J(3), Nowalany-Kozielska E(1), Lip GYH(5).
Author information:
(1)2nd Department of Cardiology in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
(2)Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland. Electronic address: [Email]
(3)Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
(4)Department of Physiology in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
(5)Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest Hospital, Liverpool, United Kingdom.

Abstract

Type 2 diabetes mellitus (DM) has a detrimental impact on cardiovascular outcomes, with implications for prognosis following ST elevation myocardial infarction (STEMI).The aim was to evaluate the impact of DM and myocardial perfusion on the long-term risk of heart failure (HF) and/or all-cause mortality following primary percutaneous coronary intervention (pPCI) for STEMI. A total of 406 STEMI patients (104 with DM) treated with pPCI were enrolled in this observational study. Myocardial perfusion was reassessed with the Quantitative Myocardial Blush Evaluator. Follow-up data on HF (ICD10 [International Statistical Classification of Diseases] codes I50.0 - I50.9) and all-cause mortality were obtained from the National Health Fund. During a 6-year follow-up, 36 (35%) patients with DM died compared with 45 (15%) patients without DM (p <0.001). Also, 24 (23%) patients with DM developed HF compared with 51 (17%) patients without DM (p = 0.20). Patients with DM and HF had the highest mortality rate (75%), and those with DM and a QuBE score below the median value (9.0 arb. units) had significantly higher risk of HF (hazard ratio [HR] =1.96, 95% CI 1.18 to 3.27, p = 0.0099) and the composite of HF and/or all-cause mortality (HR = 1.89, 95% CI 1.33 to 2.69, p = 0.0004). In conclusion DM (type 2) and diminished myocardial perfusion increase the risk of HF and/or all-cause mortality during a 6-year follow-up after pPCI for STEMI.