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Impact of diabetes on bleeding events in ST-elevation myocardial infarction patients after urgent percutaneous coronary intervention: A retrospective cohort study

机译:糖尿病对急诊经皮冠状动脉介入治疗后ST段抬高型心肌梗死患者出血事件的影响:一项回顾性队列研究

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摘要

Patients with diabetes mellitus (DM) have more ischemic events and a decreased survival rate after percutaneous coronary intervention (PCI) than non-DM patients. However, it is unknown whether short-term or long-term bleeding events are associated with DM. We aimed to determine the impact of DM on mortality and bleeding events in ST-elevation myocardial infarction (STEMI) patients after urgent PCI. This retrospective cohort study included 435 STEMI patients who had undergone urgent PCI between 2010 and 2013, comprising 97 DM patients and 338 non-DM patients. The primary outcomes were the 30-day bleeding and 30-day mortality rates. The median follow-up period was 2 years. Data regarding patient demographics, peri-PCI medication, and invasive procedures were compared between DM and non-DM patients. Multivariate logistic regression was applied to estimate the association between DM and bleeding events. Kaplan–Meier curves were calculated to elucidate the survival rate. Compared with non-DM patients, DM patients with STEMI had a higher incidence of left ventricular ejection fraction P?II (11.3% vs 3.8%, P?P?P? DM was an independent predictor for an increased risk of 30-day bleeding events and correlated with increased 30-day and 2-year mortality rates in STEMI patients with PCI. Our study has significant clinical implications for risk stratification before the application of urgent PCI.
机译:与非DM患者相比,经皮冠状动脉介入治疗(PCI)后,患有糖尿病(DM)的患者发生的缺血事件更多,存活率降低。然而,尚不清楚短期或长期出血事件与DM相关。我们旨在确定DM对紧急PCI后ST抬高型心肌梗死(STEMI)患者的死亡率和出血事件的影响。这项回顾性队列研究纳入了2010年至2013年间接受急诊PCI治疗的435例STEMI患者,包括97例DM患者和338例非DM患者。主要结果是30天出血和30天死亡率。中位随访期为2年。在DM和非DM患者之间比较了有关患者人口统计学,PCI周边药物治疗和侵入性程序的数据。应用多因素logistic回归估计DM与出血事件之间的关联。计算Kaplan–Meier曲线可阐明存活率。与非糖尿病患者相比,患有STEMI的糖尿病患者左心室射血分数P?II的发生率更高(11.3%比3.8%,P?P?P?DM是30天出血风险增加的独立预测因子事件并与STEMI合并PCI的30天和2年死亡率增加有关,我们的研究对应用紧急PCI之前的危险分层具有重要的临床意义。

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