TY - JOUR
T1 - Impact of Diabetes on 10-Year Outcomes Following ST-Segment–Elevation Myocardial Infarction
T2 - Insights From the EXAMINATION-EXTEND Trial
AU - Spione, Francesco
AU - Arevalos, Victor
AU - Gabani, Rami
AU - Ortega-Paz, Luis
AU - Gomez-Lara, Josep
AU - Jimenez-Diaz, Victor
AU - Jimenez, Marcelo
AU - Jiménez-Quevedo, Pilar
AU - Diletti, Roberto
AU - Pineda, Javier
AU - Campo, Gianluca
AU - Silvestro, Antonio
AU - Maristany, Jaume
AU - Flores, Xacobe
AU - Oyarzabal, Loreto
AU - Bastos-Fernandez, Guillermo
AU - Iñiguez, Andrés
AU - Serra, Antonio
AU - Escaned, Javier
AU - Ielasi, Alfonso
AU - Tespili, Maurizio
AU - Lenzen, Mattie
AU - Gonzalo, Nieves
AU - Bordes, Pascual
AU - Tebaldi, Matteo
AU - Biscaglia, Simone
AU - Al-Shaibani, Soheil
AU - Romaguera, Rafael
AU - Gomez-Hospital, Joan Antoni
AU - Rodes-Cabau, Josep
AU - Serruys, Patrick W.
AU - Sabaté, Manel
AU - Brugaletta, Salvatore
N1 - Funding Information:
The EXAMINATION (Clinical Evaluation of the Xience-V Stent in Acute Myocardial Infarction) trial was partially funded by an unrestricted grant from Abbott Vascular to the Spanish Heart Foundation (promoter) during the first 5years of follow-up. The EXAMINATION-EXTEND (10-Years Follow-up of the EXAMINATION Trial) study was funded by an unrestricted grant from Abbott Vascular to the Spanish Heart Foundation (promoter). Dr Spione has been supported by a research grant provided by the Cardiopath PhD program (University of Naples “Federico II”).Disclosures None.
Publisher Copyright:
© 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2022/12/6
Y1 - 2022/12/6
N2 - BACKGROUND: Long-term outcomes of ST-segment–elevation myocardial infarction in patients with diabetes have been barely investigated. The objective of this analysis from the EXAMINATION-EXTEND (10-Years Follow-Up of the EXAMINATION trial) trial was to compare 10-year outcomes of patients with ST-segment–elevation myocardial infarction with and without diabetes. METHODS AND RESULTS: Of the study population, 258 patients had diabetes and 1240 did not. The primary end point was patient-oriented composite end point of all-cause death, any myocardial infarction, or any revascularization. Secondary end points were the individual components of the primary combined end point, cardiac death, target vessel myocardial infarction, target lesion revascularization, and stent thrombosis. All end points were adjusted for potential confounders. At 10 years, patients with diabetes showed a higher incidence of patient-oriented composite end point compared with those without (46.5% versus 33.0%; adjusted hazard ratio [HR], 1.31 [95% CI, 1.05–1.61]; P=0.016) mainly driven by a higher incidence of any revascularization (24.4% versus 16.6%; adjusted HR, 1.61 [95% CI, 1.19–2.17]; P=0.002). Specifically, patients with diabetes had a higher incidence of any revascularization during the first 5 years of follow-up (20.2% versus 12.8%; adjusted HR, 1.57 [95% CI, 1.13–2.19]; P=0.007) compared with those without diabetes. No statistically significant differences were found with respect to the other end points. CONCLUSIONS: Patients with ST-segment–elevation myocardial infarction who had diabetes had worse clinical outcome at 10 years compared with those without diabetes, mainly driven by a higher incidence of any revascularizations in the first 5 years. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04462315.
AB - BACKGROUND: Long-term outcomes of ST-segment–elevation myocardial infarction in patients with diabetes have been barely investigated. The objective of this analysis from the EXAMINATION-EXTEND (10-Years Follow-Up of the EXAMINATION trial) trial was to compare 10-year outcomes of patients with ST-segment–elevation myocardial infarction with and without diabetes. METHODS AND RESULTS: Of the study population, 258 patients had diabetes and 1240 did not. The primary end point was patient-oriented composite end point of all-cause death, any myocardial infarction, or any revascularization. Secondary end points were the individual components of the primary combined end point, cardiac death, target vessel myocardial infarction, target lesion revascularization, and stent thrombosis. All end points were adjusted for potential confounders. At 10 years, patients with diabetes showed a higher incidence of patient-oriented composite end point compared with those without (46.5% versus 33.0%; adjusted hazard ratio [HR], 1.31 [95% CI, 1.05–1.61]; P=0.016) mainly driven by a higher incidence of any revascularization (24.4% versus 16.6%; adjusted HR, 1.61 [95% CI, 1.19–2.17]; P=0.002). Specifically, patients with diabetes had a higher incidence of any revascularization during the first 5 years of follow-up (20.2% versus 12.8%; adjusted HR, 1.57 [95% CI, 1.13–2.19]; P=0.007) compared with those without diabetes. No statistically significant differences were found with respect to the other end points. CONCLUSIONS: Patients with ST-segment–elevation myocardial infarction who had diabetes had worse clinical outcome at 10 years compared with those without diabetes, mainly driven by a higher incidence of any revascularizations in the first 5 years. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04462315.
UR - http://www.scopus.com/inward/record.url?scp=85143608357&partnerID=8YFLogxK
U2 - 10.1161/JAHA.122.025885
DO - 10.1161/JAHA.122.025885
M3 - Article
C2 - 36444863
AN - SCOPUS:85143608357
SN - 2047-9980
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 23
M1 - e025885
ER -
