糖尿病を合併した日本人の急性心筋梗塞の予後と治療

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Background: In the present acute reperfusion era, few studies have clarified the long-term prognosis of Japanese diabetic patients complicated with acute myocardial infarctions (AMIs). Objectives and Methods: To elucidate the long-term prognosis and prognostic factors in Japanese diabetic patients complicated with AMIs, a prospective cohort study was conducted, with 3,021 consecutive AMI patients prospectively enrolled. Among them, diabetes was diagnosed in 1,102 (36.5%). Results: During the index hospitalization, coronary angioplasty and coronary thrombolysis were performed in 58.1% and 16.3% of patients, respectively. In total, 2,736 patients (90.6%) were discharged alive and followed up for a mean of 4.2 years (follow-up rate, 96.0%). Multivariate analysis revealed that acute revascularization or prescribing aspirin and angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-II receptor blockers (ARBs) was significantly associate with favorable late outcomes in the diabetic patients with AMIs (hazard ratio [HR], 0.62,0.27 and 0.53, respectively). There was no significant correlation between the late outcome and prescription of beta-blockers, calcium channel blockers or Statins (HR, 0.97, 1.27 and 0.60, respectively). Conclusions: Although Japanese diabetic patients with AMIs also have a poorer long-term prognosis compared to non-diabetic patients with AMIs, aggressive revascularization and medication with aspirin, ACEIs and ARBs, may possibly improve their poor prognosis.
東京女子医科大学の論文

糖尿病を合併した日本人の急性心筋梗塞の予後と治療

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