Comparative effect of statin intensity between prediabetes and type 2 diabetes mellitus after implanting newer-generation drug-eluting stents in Korean acute myocardial infarction patients: a retrospective observational study.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968539 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2261 (Electronic) Linking ISSN: 14712261 NLM ISO Abbreviation: BMC Cardiovasc Disord Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Diabetes Mellitus, Type 2*/blood ; Diabetes Mellitus, Type 2*/complications ; Drug-Eluting Stents* ; Prediabetic State*/blood ; Prediabetic State*/complications; Heart Diseases/*prevention & control ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage ; Myocardial Infarction/*therapy; Cause of Death ; Female ; Glycated Hemoglobin/analysis ; Heart Diseases/epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Myocardial Infarction/blood ; Percutaneous Coronary Intervention/statistics & numerical data ; Platelet Aggregation Inhibitors/administration & dosage ; Recurrence ; Republic of Korea ; Retreatment/statistics & numerical data ; Retrospective Studies
    • Abstract:
      Background: Comparative studies regarding the long-term clinical outcomes of statin intensity between acute myocardial infarction (AMI) patients with prediabetes and those with type 2 diabetes mellitus (T2DM), after successful implantation of newer-generation drug-eluting stents (DES) with statin treatment, are limited. We compared the 2-year clinical outcomes between these patients.
      Methods: A total of 11,612 AMI patients were classified as statin users (n = 9893) and non-users (n = 1719). Thereafter, statin users were further divided into high-intensity (n = 2984) or low-moderate-intensity statin (n = 6909) treatment groups. Those in these two groups were further classified into patients with normoglycemia, prediabetes, and T2DM. The major outcomes were the occurrence of major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (Re-MI), or any repeat coronary revascularization.
      Results: After adjusting for both high-intensity and low-moderate-intensity statin users, the cumulative incidences of MACE (p = 0.737, p = 0.062, respectively), all-cause death, Re-MI, and any repeat revascularization were similar between the prediabetes and T2DM groups. In the total study population, both high-intensity and low-moderate-intensity statin treatments showed comparable results. However, in the patients who enrolled after October 2012, the cumulative incidences of MACE (aHR 1.533; 95% CI 1.144-2.053; p = 0.004) and any repeat revascularization (aHR, 1.587; 95% CI 1.026-2.456; p = 0.038) were significantly lower in high-intensity statin users than in low-moderate intensity statin users. The beneficial effects of high-intensity compared to low-moderate-intensity statin therapy were more apparent in the normoglycemia group than hyperglycemia group, as it reduced the cumulative incidences of MACE (aHR 1.903; 95% CI 1.203-3.010; p = 0.006) and any repeat revascularization (aHR 3.248; 95% CI 1.539-6.854; p = 0.002).
      Conclusions: In this retrospective registry study, prediabetes and T2DM groups showed comparable clinical outcomes, after administering both high-intensity and low-moderate-intensity statin treatments. However, these results are likely to be clearly proved by further studies, especially in patients with AMI who are being treated in contemporary practice.
      Trial Registration: Retrospectively registered.
      (© 2021. The Author(s).)
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    • Contributed Indexing:
      Keywords: Diabetes; Myocardial infarction; Outcomes; Prediabetes; Statin
    • Accession Number:
      0 (Glycated Hemoglobin A)
      0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
      0 (Platelet Aggregation Inhibitors)
      0 (hemoglobin A1c protein, human)
    • Publication Date:
      Date Created: 20210810 Date Completed: 20211227 Latest Revision: 20221207
    • Publication Date:
      20221213
    • Accession Number:
      PMC8351104
    • Accession Number:
      10.1186/s12872-021-02198-w
    • Accession Number:
      34372778