医学
内科学
心肌梗塞
危险系数
心脏病学
糖尿病前期
临床终点
冲程(发动机)
2型糖尿病
糖尿病
置信区间
随机对照试验
内分泌学
机械工程
工程类
作者
Yong Hoon Kim,Ae Young Her,Jeong Gwan Cho,Byeong‐Keuk Kim,Sung Jin Hong,Seunghwan Kim,Chul‐Min Ahn,Jung Sun Kim,Young Guk Ko,Donghoon Choi,Myeong Ki Hong,Yangsoo Jang
标识
DOI:10.1016/j.amjms.2022.05.016
摘要
Background Smoking is linked with increased risk of cardiovascular events among diabetic patients. Prediabetes is associated with increased risk for microvascular and macrovascular complications. We compared the 2-year clinical outcomes of current smoking between prediabetic and type 2 diabetes mellitus (T2DM) patients with acute myocardial infarction (AMI) after newer-generation drug-eluting stent (DES) implantation. Methods A total of 5161 AMI patients who were currently smoking were classified into normoglycemia (group A: 1,416), prediabetes (group B: 1,740), and T2DM (group C: 2,005) groups. The primary endpoint was major adverse cardiac events (MACEs), defined as all-cause death, recurrent myocardial infarction and any repeat revascularization. The secondary endpoint was the occurrence of stent thrombosis (ST) and stroke. Results The cumulative incidences of all primary and secondary endpoints including MACEs (adjusted hazard ratio [aHR]: 1.150; 95% confidence interval [CI]: 0.891–1.484; P = 0.284), ST, and stroke were similar between group B and group C. The cumulative incidences of MACEs (aHR: 1.385; 95% CI: 1.007–1.904; P = 0.045) and all-cause death or MI were significantly higher in group B than in group A. The cumulative incidences of MACEs (aHR: 1.572; 95% CI: 1.157–2.137; P = 0.004), all-cause death, Re-MI, and all-cause death or MI were significantly higher in group C than in group A. Conclusions Current smoking leads to worse clinical outcomes in patients with AMI and prediabetes, and thus, similarly to T2DM patients, more attention and more intensive treatment strategy including quitting smoking would be advantageous.
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