TY - JOUR
T1 - Regional differences in percutaneous coronary intervention outcomes in STEMI patients with diabetes
T2 - The Asia-Pacific evaluation of cardiovascular therapies (ASPECT) collaboration
AU - Wong, Mark Y.Z.
AU - Yap, Jonathan J.L.
AU - Chih, Hui Jun
AU - Yan, Bryan P.Y.
AU - Fong, Alan Y.Y.
AU - Beltrame, John F.
AU - Wijaya, Ika Prasetya
AU - Nguyen, Hoai T.T.
AU - Brennan, Angela L.
AU - Reid, Christopher M.
AU - Yeo, Khung Keong
N1 - Funding Information:
The ASPECT Collaboration activities are supported through a NHMRC Program Grant 546272 and CMR is supported by a NHMRC Principal Re- search Fellowship App: 1136372. ASPECT acknowledges the contribution of all data managers and clinicians participating in country specific registries.
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2023/1/15
Y1 - 2023/1/15
N2 - Background: Diabetes is associated with poorer outcomes and increased complication rates in STEMI patients undergoing percutaneous coronary intervention (PCI). Data are notably lacking in the Asia-Pacific region. We report the overall association of Diabetes with clinical characteristics and outcomes in STEMI patients undergoing PCI across the Asia-Pacific, with a particular focus on regional differences. Methodology: The Asia Pacific Evaluation of Cardiovascular Therapies (ASPECT) collaboration consists of data from various PCI registries across Australia, Hong Kong, Singapore, Malaysia, Indonesia and Vietnam. Clinical characteristics, lesion characteristics, and outcomes were provided for STEMI patients. Key outcomes included 30-day overall mortality and major adverse cardiovascular events (MACE). Results: A total of 12,144 STEMI patients (mean(SD) age 59.3(12.3)) were included, of which 3912 (32.2%) had diabetes. Patients with diabetes were likely to have a higher baseline risk profile, poorer clinical presentation, and more complex lesion patterns (all p < 0.05). Across all regions, patients with diabetes had a higher rate of 30-day mortality and MACE (all p < 0.05). After multivariable adjustment, diabetes was significantly associated with both increased 30-day mortality (9.6%vs 5.5%, OR 1.79 [95% CI 1.40–2.30]) and MACE (13.3% vs 8.6%, R 1.73 [1.44–2.08]). The association between diabetes and 30-day MACE varied by region (pinteraction = 0.041), with the association (OR) ranging from 1.34 [1.08–1.67] in Malaysia, to 2.39 [1.66–3.45] in Singapore. Conclusions: Diabetes portends poorer clinical outcomes in STEMI patients undergoing PCI in the Asia-Pacific with regional variations noted. The development of effective preventative measures and interventional strategies targetted at this high-risk group is crucial.
AB - Background: Diabetes is associated with poorer outcomes and increased complication rates in STEMI patients undergoing percutaneous coronary intervention (PCI). Data are notably lacking in the Asia-Pacific region. We report the overall association of Diabetes with clinical characteristics and outcomes in STEMI patients undergoing PCI across the Asia-Pacific, with a particular focus on regional differences. Methodology: The Asia Pacific Evaluation of Cardiovascular Therapies (ASPECT) collaboration consists of data from various PCI registries across Australia, Hong Kong, Singapore, Malaysia, Indonesia and Vietnam. Clinical characteristics, lesion characteristics, and outcomes were provided for STEMI patients. Key outcomes included 30-day overall mortality and major adverse cardiovascular events (MACE). Results: A total of 12,144 STEMI patients (mean(SD) age 59.3(12.3)) were included, of which 3912 (32.2%) had diabetes. Patients with diabetes were likely to have a higher baseline risk profile, poorer clinical presentation, and more complex lesion patterns (all p < 0.05). Across all regions, patients with diabetes had a higher rate of 30-day mortality and MACE (all p < 0.05). After multivariable adjustment, diabetes was significantly associated with both increased 30-day mortality (9.6%vs 5.5%, OR 1.79 [95% CI 1.40–2.30]) and MACE (13.3% vs 8.6%, R 1.73 [1.44–2.08]). The association between diabetes and 30-day MACE varied by region (pinteraction = 0.041), with the association (OR) ranging from 1.34 [1.08–1.67] in Malaysia, to 2.39 [1.66–3.45] in Singapore. Conclusions: Diabetes portends poorer clinical outcomes in STEMI patients undergoing PCI in the Asia-Pacific with regional variations noted. The development of effective preventative measures and interventional strategies targetted at this high-risk group is crucial.
KW - Asia-Pacific
KW - Diabetes
KW - Percutaneous coronary intervention
KW - Regional differences
KW - STEMI
UR - http://www.scopus.com/inward/record.url?scp=85143916984&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2022.10.001
DO - 10.1016/j.ijcard.2022.10.001
M3 - Article
C2 - 36220505
AN - SCOPUS:85143916984
SN - 0167-5273
VL - 371
SP - 84
EP - 91
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -
