ONE-YEAR OUTCOMES OF DIABETIC VERSUS NONDIABETIC PATIENTS WITH NON-Q-WAVE ACUTE MYOCARDIAL-INFARCTION TREATED WITH PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

Risk factors and outcomes associated with non-Q-wave myocardial infarc tion (MI) in diabetics and non-diabetics were analyzed for 376 consecu tive patients, 77 with diabetes (20%) and 299 nondiabetics (80%), who had non-Q-wave MI and had percutaneous transluminal coronary angioplas ty (PTCA) performed before discharge from hospital during the period f rom January 1992 to February 1996. Diabetics were slightly older (64 /- 10 years vs 61 +/- 12 years, p <0.053), had more prior coronary art ery bypass grafting (CABG) surgery (27% vs 12%, p <0.001), and hyperte nsion (77% vs 49%, p <0.001). There was no significant difference in u nstable angina, saphenous vein graft PTCA, single versus multiple vess el disease, or history of MI. PTCA success rates for diabetics versus nondiabetics were similar (96% vs 97%, p = NS). In-hospital complicati ons such CABG, recurrent MI, repeat PTCA, stroke, and death were not s tatistically significant between the 2 groups. At 1-year follow-up, su rvival in diabetics (92%) was similar to nondiabetics (94%, p = NS), a lthough event-free survival (PTCA, CABG, MI, death) was worse in diabe tics (55% vs 67% for nondiabetics, p <0.05). Although diabetic patient s with non-Q-wave MI represent a cohort with more risk factors for poo r outcome, aggressive in-hospital revascularization with PTCA results in an excellent short-term outcome as well as 1-year survival similar to the nondiabetic patients. However, total events at 1-year follow-up are more common in the diabetic patients, suggesting that more aggres sive screening and therapy in follow-up may be warranted, and that a d iabetic with non-Q-wave MI will require increased utilization of cardi ovascular resources in the first year after the event. (C) 1998 by Exc erpta Medica, Inc.