The Korean journal of internal medicine

  • 제39권1호
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  • Pages.110-122
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  • 2024
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Time to presentation and mortality outcomes among patients with diabetes and acute myocardial infarction

  • Min-A Shin (Department of Cardiology, Chonnam National University Hospital) ;
  • Seok Oh (Department of Cardiology, Chonnam National University Hospital) ;
  • Min Chul Kim (Department of Cardiology, Chonnam National University Hospital) ;
  • Doo Sun Sim (Department of Cardiology, Chonnam National University Hospital) ;
  • Young Joon Hong (Department of Cardiology, Chonnam National University Hospital) ;
  • Ju Han Kim (Department of Cardiology, Chonnam National University Hospital) ;
  • Youngkeun Ahn (Department of Cardiology, Chonnam National University Hospital) ;
  • Myung Ho Jeong (Department of Cardiology, Chonnam National University Hospital)
  • 투고 : 2023.07.21
  • 심사 : 2023.09.25
  • 발행 : 2024.01.01
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초록

Background/Aims: Due to limited real-world evidence on the association between time to presentation (T2P) and outcomes following acute myocardial infarction and diabetes (AMI-DM), we investigated the characteristics of patients with AMI-DM and their outcomes based on their T2P. Methods: 4,455 patients with AMI-DM from a Korean nationwide observational cohort (2011-2015) were divided into early and late presenters according to symptom-to-door time. The effects of T2P on three-year all-cause mortality were estimated using inverse probability of treatment weighting (IPTW) and survival analysis. Results: The incidence of all-cause mortality was consistently higher in late presenters than in early presenters (11.4 vs. 17.2%; p < 0.001). In the IPTW-adjusted dataset, the incidence of all-cause mortality was numerically higher in late presenters than in early presenters (9.1 vs. 12.4%; p = 0.072). In the survival analysis, the cumulative incidence of all-cause mortality was significantly higher in late presenters than in early presenters before and after IPTW. In the subgroup with ST-elevation myocardial infarction, late presenters had a higher incidence of cardiac death than early presenters before (4.8 vs. 10.5%; p < 0.001) and after IPTW (4.2 vs. 9.7%; p = 0.034). In the initial glycated hemoglobin (HbA1c)-stratified analysis, these effects were attenuated in patients with HbA1c ≥ 9.0% before (adjusted hazard ratio [HR]: 1.45, 95% confidence interval [CI]: 0.80-2.64) and after IPTW (adjusted HR: 0.82, 95% CI: 0.40-1.67). Conclusions: Late presentation was associated with higher mortality in patients with AMI-DM; therefore, multifaceted and systematic interventions are needed to decrease pre-hospital delays.

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과제정보

We politely disclose that this original article is a continuation of the work presented in Min-A Shin's Master's dissertation.

참고문헌

  1. Knuuti J, Wijns W, Saraste A, et al.; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 2020;41:407-477.  https://doi.org/10.1093/eurheartj/ehz425
  2. Avogaro A, Bonora E, Consoli A, Del Prato S, Genovese S, Giorgino F. Glucose-lowering therapy and cardiovascular outcomes in patients with type 2 diabetes mellitus and acute coronary syndrome. Diab Vasc Dis Res 2019;16:399-414.  https://doi.org/10.1177/1479164119845612
  3. Lyu YS, Oh S, Kim JH, Kim SY, Jeong MH. Comparison of SGLT2 inhibitors with DPP-4 inhibitors combined with metformin in patients with acute myocardial infarction and diabetes mellitus. Cardiovasc Diabetol 2023;22:185. 
  4. El-Menyar A, Zubaid M, Sulaiman K, et al.; Gulf Registry of Acute Coronary Events (Gulf RACE) Investigators. Atypical presentation of acute coronary syndrome: a significant independent predictor of in-hospital mortality. J Cardiol 2011;57:165-171.  https://doi.org/10.1016/j.jjcc.2010.11.008
  5. Sheifer SE, Rathore SS, Gersh BJ, et al. Time to presentation with acute myocardial infarction in the elderly: associations with race, sex, and socioeconomic characteristics. Circulation 2000;102:1651-1656.  https://doi.org/10.1161/01.CIR.102.14.1651
  6. Cha JJ, Bae S, Park DW, et al. Clinical outcomes in patients with delayed hospitalization for non-ST-segment elevation myocardial infarction. J Am Coll Cardiol 2022;79:311-323. 
  7. Kim JH, Chae SC, Oh DJ, et al.; Korea Acute Myocardial Infarction-National Institutes of Health Registry Investigators. Multicenter cohort study of acute myocardial infarction in Korea - interim analysis of the Korea Acute Myocardial Infarction Registry-National Institutes of Health Registry. Circ J 2016;80:1427-1436.  https://doi.org/10.1253/circj.CJ-16-0061
  8. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013;310:2191-2194.  https://doi.org/10.1001/jama.2013.281053
  9. Ibanez B, James S, Agewall S, et al.; ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018;39:119-177.  https://doi.org/10.1093/eurheartj/ehx393
  10. Roffi M, Patrono C, Collet JP, et al.; ESC Scientific Document Group. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J 2016;37:267-315.  https://doi.org/10.1093/eurheartj/ehv320
  11. Stone GW, Brodie BR, Griffin JJ, et al. Prospective, multicenter study of the safety and feasibility of primary stenting in acute myocardial infarction: in-hospital and 30-day results of the PAMI stent pilot trial. Primary Angioplasty in Myocardial Infarction Stent Pilot Trial Investigators. J Am Coll Cardiol 1998;31:23-30. 
  12. Ellis SG, Vandormael MG, Cowley MJ, et al. Coronary morphologic and clinical determinants of procedural outcome with angioplasty for multivessel coronary disease. Implications for patient selection. Multivessel Angioplasty Prognosis Study Group. Circulation 1990;82:1193-1202.  https://doi.org/10.1161/01.CIR.82.4.1193
  13. Lee M, Kim DW, Park MW, et al. Gender differences in clinical outcomes of acute myocardial infarction undergoing percutaneous coronary intervention: insights from the KAMIR-NIH Registry. J Geriatr Cardiol 2020;17:680-693. 
  14. Cho KH, Han X, Ahn JH, et al.; KAMIR-NIH Investigators. Long-term outcomes of patients with late presentation of ST-segment elevation myocardial infarction. J Am Coll Cardiol 2021;77:1859-1870. 
  15. Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res 2011;46:399-424.  https://doi.org/10.1080/00273171.2011.568786
  16. Austin PC, Stuart EA. Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies. Stat Med 2015;34:3661-3679.  https://doi.org/10.1002/sim.6607
  17. Brieger D, Eagle KA, Goodman SG, et al.; GRACE Investigators. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: insights from the Global Registry of Acute Coronary Events. Chest 2004;126:461-469.  https://doi.org/10.1378/chest.126.2.461
  18. Wenger NK. Angina in women. Curr Cardiol Rep 2010;12:307-314.  https://doi.org/10.1007/s11886-010-0111-z
  19. Lee SH, Kim HK, Jeong MH, et al.; KAMIR Investigators. Pre-hospital delay and emergency medical services in acute myocardial infarction. Korean J Intern Med 2020;35:119-132.  https://doi.org/10.3904/kjim.2019.123
  20. Pampel FC. Global patterns and determinants of sex differences in smoking. Int J Comp Sociol 2006;47:466-487.  https://doi.org/10.1177/0020715206070267
  21. Oh S, Kim JH, Cho KH, et al. Association between baseline smoking status and clinical outcomes following myocardial infarction. Front Cardiovasc Med 2022;9:918033. 
  22. Bailleul C, Aissaoui N, Cayla G, et al.; FAST-MI investigators. Prognostic impact of prepercutaneous coronary intervention TIMI flow in patients with ST-segment and non-ST-segment elevation myocardial infarction: results from the FAST-MI 2010 registry. Arch Cardiovasc Dis 2018;111:101-108.  https://doi.org/10.1016/j.acvd.2017.04.004
  23. Karwowski J, Polonski L, Gierlotka M, et al. Total coronary occlusion of infarct-related arteries in patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary revascularisation. Kardiol Pol 2017;75:108-116.  https://doi.org/10.5603/KP.a2016.0130
  24. Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC); Steg PG, James SK, Atar D, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2012;33:2569-2619.  https://doi.org/10.1093/eurheartj/ehs215
  25. Oh S, Jeong MH, Cho KH, et al. Outcomes of nonagenarians with acute myocardial infarction with or without coronary intervention. J Clin Med 2022;11:1593. 
  26. Nilsson G, Mooe T, Soderstrom L, Samuelsson E. Pre-hospital delay in patients with first time myocardial infarction: an observational study in a northern Swedish population. BMC Cardiovasc Disord 2016;16:93. 
  27. Yoon CW, Oh H, Lee J, et al. Comparisons of prehospital delay and related factors between acute ischemic stroke and acute myocardial infarction. J Am Heart Assoc 2022;11:e023214. 
  28. Fu R, Li SD, Song CX, et al. Clinical significance of diabetes on symptom and patient delay among patients with acute myocardial infarction-an analysis from China Acute Myocardial Infarction (CAMI) registry. J Geriatr Cardiol 2019;16:395-400. 
  29. Wackers FJ, Young LH, Inzucchi SE, et al.; Detection of Ischemia in Asymptomatic Diabetics Investigators. Detection of silent myocardial ischemia in asymptomatic diabetic subjects: the DIAD study. Diabetes Care 2004;27:1954-1961.  https://doi.org/10.2337/diacare.27.8.1954
  30. Kim I, Kim MC, Park KH, et al. Prognostic significance of non-chest pain symptoms in patients with non-ST-segment elevation myocardial infarction. Korean J Intern Med 2018;33:1111-1118.  https://doi.org/10.3904/kjim.2017.071
  31. Oh S, Hyun DY, Cho KH, Kim JH, Jeong MH. Long-term outcomes in ST-elevation myocardial infarction patients treated according to hospital visit time. Korean J Intern Med 2022;37:605-617.  https://doi.org/10.3904/kjim.2021.204
  32. Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomark Insights 2016;11:95-104.  https://doi.org/10.4137/BMI.S38440
  33. Kim YH, Her AY, Rha SW, et al. 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. Catheter Cardiovasc Interv 2023;101:1014-1027.  https://doi.org/10.1002/ccd.30630
  34. Mather AN, Crean A, Abidin N, et al. Relationship of dysglycemia to acute myocardial infarct size and cardiovascular outcome as determined by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2010;12:61. 
  35. Avogaro A, Albiero M, Menegazzo L, de Kreutzenberg S, Fadini GP. Endothelial dysfunction in diabetes: the role of reparatory mechanisms. Diabetes Care 2011;34 Suppl 2(Suppl 2):S285-S290.  https://doi.org/10.2337/dc11-s239
  36. Burgess S, Juergens CP, Yang W, et al. Cardiac mortality, diabetes mellitus, and multivessel disease in ST elevation myocardial infarction. Int J Cardiol 2021;323:13-18.  https://doi.org/10.1016/j.ijcard.2020.08.021
  37. Kim YH, Her AY, Rha SW, et al. Effect of delayed hospitalization on 3-year clinical outcomes according to renal function in patients with non-ST-segment elevation myocardial infarction. Cardiol J 2023 May 29 [Epub]. DOI: 10.5603/CJ.a2023.0036. 
  38. Basalay MV, Yellon DM, Davidson SM. Targeting myocardial ischaemic injury in the absence of reperfusion. Basic Res Cardiol 2020;115:63. 
  39. Kim YH, Her AY, Rha SW, et al. Outcomes of early versus delayed invasive strategy in older adults with non-ST-segment elevation myocardial infarction. Sci Rep 2022;12:11429. 
  40. Panoulas V, Rathod KS, Jain AK, et al. Impact of early (≤24 h) versus delayed (>24 h) intervention in patients with nonST segment elevation myocardial infarction: an observational study of 20,882 patients from the London Heart Attack Group. Cardiovasc Revasc Med 2021;22:3-7.  https://doi.org/10.1016/j.carrev.2020.06.001
  41. Li Y, Zhang Z, Xiong X, et al. Immediate/early vs. delayed invasive strategy for patients with non-ST-segment elevation acute coronary syndromes: a systematic review and meta-analysis. Front Physiol 2017;8:952. 
  42. Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. Cardiorenal syndrome. J Am Coll Cardiol 2008;52:1527-1539.  https://doi.org/10.1016/j.jacc.2008.07.051
  43. Kim MC, Cho JY, Jeong HC, et al. Long-term clinical outcomes of transient and persistent no reflow phenomena following percutaneous coronary intervention in patients with acute myocardial infarction. Korean Circ J 2016;46:490-498.  https://doi.org/10.4070/kcj.2016.46.4.490
  44. Ibanez B, Heusch G, Ovize M, Van de Werf F. Evolving therapies for myocardial ischemia/reperfusion injury. J Am Coll Cardiol 2015;65:1454-1471.  https://doi.org/10.1016/j.jacc.2015.02.032
  45. Kim MC, Jeong MH, Sim DS, et al.; KAMIR-NIH registry investigators. Optimal timing of percutaneous coronary intervention in patients with non-ST-segment elevation myocardial infarction complicated by acute decompensated heart failure (from the Korea Acute Myocardial Infarction Registry-National Institutes of Health [KAMIR-NIH]). Am J Cardiol 2018;121:1285-1292.  https://doi.org/10.1016/j.amjcard.2018.01.051
  46. Canto AJ, Kiefe CI, Goldberg RJ, et al. Differences in symptom presentation and hospital mortality according to type of acute myocardial infarction. Am Heart J 2012;163:572-579.  https://doi.org/10.1016/j.ahj.2012.01.020
  47. Cho JY, Jeong MH, Ahn YK, et al.; Korea Acute Myocardial Infarction Registry Investigators. Comparison of outcomes of patients with painless versus painful ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention. Am J Cardiol 2012;109:337-343.  https://doi.org/10.1016/j.amjcard.2011.09.017
  48. Fujino M, Ishihara M, Ogawa H, et al.; J-MINUET Investigators. Impact of symptom presentation on in-hospital outcomes in patients with acute myocardial infarction. J Cardiol 2017;70:29-34. https://doi.org/10.1016/j.jjcc.2016.10.002