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- Title
Combined risk estimates of diabetes and coronary angiography-derived index of microcirculatory resistance in patients with non-ST elevation myocardial infarction.
- Authors
Chen, Delong; Zhang, Yuxuan; Yidilisi, Abuduwufuer; Hu, Die; Zheng, Yiyue; Fang, Jiacheng; Gong, Qinyan; Huang, Jiniu; Dong, Qichao; Pu, Jun; Niu, Tiesheng; Xiang, Jianping; Wang, Jian'an; Jiang, Jun
- Abstract
Background: Diabetes mellitus (DM) and coronary microvascular dysfunction (CMD) increase the risk of adverse cardiac events in patients with non-ST-segment elevation myocardial infarction (NSTEMI). This study aimed to evaluate the combined risk estimates of DM and CMD, assessed by the angiography-derived index of microcirculatory resistance (angio-IMR), in patients with NSTEMI. Methods: A total of 2212 patients with NSTEMI who underwent successful percutaneous coronary intervention (PCI) were retrospectively enrolled from three centers. The primary outcome was a composite of cardiac death or readmission for heart failure at a 2-year follow-up. Results: Post-PCI angio-IMR did not significantly differ between the DM group and the non-DM group (20.13 [17.91–22.70] vs. 20.19 [18.14–22.77], P = 0.530). DM patients exhibited a notably higher risk of cardiac death or readmission for heart failure at 2 years compared to non-DM patients (9.5% vs. 5.4%, P < 0.001). NSTEMI patients with both DM and CMD experienced the highest cumulative incidence of cardiac death or readmission for heart failure at 2 years (24.0%, P < 0.001). The combination of DM and CMD in NSTEMI patients were identified as the most powerful independent predictor for cardiac death or readmission for heart failure at 2 years (adjusted HR: 7.894, [95% CI, 4.251–14.659], p < 0.001). Conclusions: In patients with NSTEMI, the combination of DM and CMD is an independent predictor of cardiac death or readmission for heart failure. Angio-IMR could be used as an additional evaluation tool for the management of NSTEMI patients with DM. Trial registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05696379.
- Subjects
NON-ST elevated myocardial infarction; MYOCARDIAL infarction; MICROCIRCULATION disorders; HEART failure; PERCUTANEOUS coronary intervention
- Publication
Cardiovascular Diabetology, 2024, Vol 23, Issue 1, p1
- ISSN
1475-2840
- Publication type
Article
- DOI
10.1186/s12933-024-02400-1