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Effects of delayed hospitalization on the 3-year clinical outcomes of patients with or without diabetes who had non-ST-segment-elevation myocardial infarction and underwent new-generation drug-eluting stent implantation

Authors
Kim, Yong HoonHer, Ae-YoungRha, Seung-WoonChoi, Cheol UngChoi, Byoung GeolKim, Ji BakKang, Dong OhPark, Ji YoungPark, Sang-HoJeong, Myung Ho
Issue Date
May-2023
Publisher
John Wiley & Sons Inc.
Keywords
diabetes mellitus; drug-eluting stent; non-ST-segment-elevation myocardial infarction; prehospital delay
Citation
Catheterization and Cardiovascular Interventions, v.101, no.6, pp 1014 - 1027
Pages
14
Journal Title
Catheterization and Cardiovascular Interventions
Volume
101
Number
6
Start Page
1014
End Page
1027
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/22568
DOI
10.1002/ccd.30630
ISSN
1522-1946
1522-726X
Abstract
Clinical outcomes after non-ST-segment-elevation myocardial infarction (NSTEMI) in patients with (symptom-to-door time [SDT] >= 24 h) or without (SDT < 24 h) delayed hospitalization among patients with or without diabetes were compared. From the Korea Acute Myocardial Infarction Registry-National Institute of Health, a total of 4517 patients with NSTEMI who underwent new-generation drug-eluting stents implantation were recruited and they were classified into the diabetes mellitus (DM) and non-DM groups. These two groups were subdivided into groups with and without delayed hospitalization. The primary clinical outcome was the occurrence of major adverse cardiac and cerebrovascular events (MACCE), defined as all-cause death, recurrent myocardial infarction, repeat coronary revascularization, and stroke. The secondary clinical outcome was the occurrence of individual components of MACCE and stent thrombosis. Although after multivariable and propensity score-adjusted analyses in the DM group, the primary and secondary clinical outcomes between the SDT < 24 h and SDT >= 24 h groups were similar; in the non-DM group, all-cause (p = 0.003 and p = 0.007, respectively) and cardiac (p = 0.001 and p = 0.008, respectively) death rates were significantly higher in the SDT >= 24 h group than in the SDT < 24 h group. Our results suggested that there was no significant difference in prognosis between diabetic patients with and without delayed SDT, but delayed SDT was associated with poor prognosis in nondiabetic patients.
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